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NPI Code Detail

MEDICARE: JENNIFER MOULTON

MEDICARE:   JENNIFER  MOULTON
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 PathologistSL014801PA

General Provider Information

NPI Number : 1598315525
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MOULTON
Provider Business Mailing Address
First Line : 1345 ENTERPRISE DR
Second Line :
City : WEST CHESTER
State : PA
Zip : 19380-5964
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1405 SHADY AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15217-1350
Country : US
Telephone Number : 412-420-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2019
Last Update Date : 06/02/2026

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Directions to “ JENNIFER MOULTON ” Practice Location

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