Healthcare Provider Details

I. General information

NPI: 1154917565
Provider Name (Legal Business Name): JENNIFER ROUTIER CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2020
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2093
US

IV. Provider business mailing address

30 LOCUST ST
NORTHAMPTON MA
01060-2093
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-2000
  • Fax:
Mailing address:
  • Phone: 413-582-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number77813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: