| Doctor Name: | MRS. JENNIFER RAE PHILLIPS |
| NPI Number: | 1477567675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP/L |
| License Number: | 02324358 |
| Business Practice Address: | 774 Fairmount Ave Jamestown, NY - 147012609 |
| Business Phone Number: | 7163380668 |
| Business Fax Number: | 8666944979 |
| Mailing Address: | 774 Fairmount Ave, JAMESTOWN |
| State: | NY |
| Postal Code: | 147012609 |
| Phone Number: | 7163380668 |
| Fax Number: | 8666944979 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 02324358 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |