| Doctor Name: | MISS JENNIFER BROOKE IVEY |
| NPI Number: | 1912153446 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | TSLP5956 |
| Business Practice Address: | 828 S Bascom Ave Suite 100 San Jose, CA - 951282651 |
| Business Phone Number: | 4087935959 |
| Business Fax Number: | 4087934244 |
| Mailing Address: | 175 Hardy Ave, CAMPBELL |
| State: | CA |
| Postal Code: | 950081923 |
| Phone Number: | 5205912248 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2008 |
| NPI Last Update Date: | 09/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | TSLP5956 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| 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 |