Doctor Name: | JENNIFER RUTLEDGE |
NPI Number: | 1609222835 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SA3641 |
Business Practice Address: | 411 E Main St Suite 204 Lakeland, FL - 33801 |
Business Phone Number: | 8636179400 |
Business Fax Number: | 8636889858 |
Mailing Address: | 411 E Main St, Suite 204 LAKELAND |
State: | FL |
Postal Code: | 33801 |
Phone Number: | 8636179400 |
Fax Number: | 8636889858 |
NPI Enumeration Date: | 05/06/2016 |
NPI Last Update Date: | 05/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA3641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |