Doctor Name: | MISS JENNIFER LEE MESA |
NPI Number: | 1942500558 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SZ5130 |
Business Practice Address: | 17906 Sw 29th St Miramar, FL - 330295155 |
Business Phone Number: | 9542582560 |
Business Fax Number: | 9544386539 |
Mailing Address: | 17906 Sw 29th St, MIRAMAR |
State: | FL |
Postal Code: | 330295155 |
Phone Number: | 9542582560 |
Fax Number: | 9544386539 |
NPI Enumeration Date: | 10/28/2010 |
NPI Last Update Date: | 10/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ5130 |
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 |