Healthcare Provider Details
I. General information
NPI: 1346457421
Provider Name (Legal Business Name): JENNIFER R. HENDRIX MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 09/01/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 W. BOYD ST.
NORMAN OK
73069-4801
US
IV. Provider business mailing address
1201 W. BOYD ST.
NORMAN OK
73069-4801
US
V. Phone/Fax
- Phone: 405-366-7898
- Fax: 405-366-0010
- Phone: 405-366-7898
- Fax: 405-366-0010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SA4787 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 205 |
| License Number State | AK |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 2336 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: