Healthcare Provider Details

I. General information

NPI: 1912111774
Provider Name (Legal Business Name): JENNIFER L. WOIT SP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 E STATE ST
SALEM OH
44460-2423
US

IV. Provider business mailing address

1152 TERRAHO DR
SALEM OH
44460-9724
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-7533
  • Fax:
Mailing address:
  • Phone: 330-537-2389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-3950
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: