Healthcare Provider Details

I. General information

NPI: 1508009358
Provider Name (Legal Business Name): JENNIFER1 JONES M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 04/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E ATLANTIC BLVD # 307
POMPANO BEACH FL
33060-6353
US

IV. Provider business mailing address

13278 NW 5TH ST
PLANTATION FL
33325-2100
US

V. Phone/Fax

Practice location:
  • Phone: 954-370-1145
  • Fax:
Mailing address:
  • Phone: 954-608-7309
  • Fax: 954-252-4269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: