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General NPI Number Information
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NPI Number | 1194873505
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Entity Type | Individual
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Provider Name | JENNIFER R ALTEMUELLER SP
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 19413 BONANZA KING DR
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City | COTTONWOOD
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State | CA
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Zip | 96022-7630
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Country | US
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Telephone | 530-917-9701
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Fax | 530-348-6971
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Provider Business Mailing Address
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Address Line | 19413 BONANZA KING DR
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City | COTTONWOOD
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State | CA
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Zip | 96022-7630
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Country | US
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Telephone | 530-917-9701
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Fax | 530-348-6971
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP12275
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License Number State | CA
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