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NPI Code Detail

MEDICARE: MRS. JENNIFER LEIGH ARCHER MS, CCC-SLP

MEDICARE: MRS. JENNIFER LEIGH ARCHER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist102449TX

General Provider Information

NPI Number : 1598246266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LEIGH ARCHER MS, CCC-SLP
Provider Business Mailing Address
First Line : 6385 SHADYWOOD DR
Second Line :
City : FRISCO
State : TX
Zip : 75035-7211
Country : US
Telephone Number : 972-369-2130
Fax Number :
Provider Business Practice Location Address
First Line : 8300 ELDORADO PKWY
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-5946
Country : US
Telephone Number : 972-548-9339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2018
Last Update Date : 08/22/2018

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