Healthcare Provider Details

I. General information

NPI: 1912152935
Provider Name (Legal Business Name): JENNIFER ANNE KLINKHAMMER M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 INDIAN HILLS RD.
BROOKINGS SD
57006-3659
US

IV. Provider business mailing address

1155 INDIAN HILLS RD.
BROOKINGS SD
57006-3659
US

V. Phone/Fax

Practice location:
  • Phone: 605-697-3091
  • Fax:
Mailing address:
  • Phone: 605-697-3091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: