Doctor Name: | JAIME TENNYSON |
NPI Number: | 1710966973 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 12071582 |
Business Practice Address: | 13325 Shiloh Rd Conifer, CO - 804335103 |
Business Phone Number: | 3039101554 |
Business Fax Number: | 3034842524 |
Mailing Address: | 13325 Shiloh Rd, CONIFER |
State: | CO |
Postal Code: | 804335103 |
Phone Number: | 3039101554 |
Fax Number: | 3034842524 |
NPI Enumeration Date: | 01/15/2006 |
NPI Last Update Date: | 03/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12071582 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |