MEDICARE: MRS. JANE GADDIS DENNEHY 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
1	235Z00000X	Speech-Language Pathologist	41YS00057500	NJ
2	235Z00000X	Speech-Language Pathologist	4625	NY

General Provider Information

NPI Number	:	1750452967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANE GADDIS DENNEHY MS, CCC-SLP

Provider Business Mailing Address
First Line	:	4 GREENE CT
Second Line	:
City	:	WEST WINDSOR
State	:	NJ
Zip	:	08550-4902
Country	:	US
Telephone Number	:	609-799-3403
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 GREENE CT
Second Line	:
City	:	WEST WINDSOR
State	:	NJ
Zip	:	08550-4902
Country	:	US
Telephone Number	:	609-799-3403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. JANE GADDIS DENNEHY MS, CCC-SLP” Practice Location

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