Doctor Name: | JENNIFER DIANNE WADSWORTH |
NPI Number: | 1770864977 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 1162 |
Business Practice Address: | 1700 Lanakila Ave Rm 210 Honolulu, HI - 968172115 |
Business Phone Number: | 8088325688 |
Business Fax Number: | 8088325698 |
Mailing Address: | 1700 Lanakila Ave Rm 210, HONOLULU |
State: | HI |
Postal Code: | 968172115 |
Phone Number: | 8088325688 |
Fax Number: | 8088325698 |
NPI Enumeration Date: | 08/31/2011 |
NPI Last Update Date: | 08/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1162 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | HI |
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 |