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General NPI Number Information
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NPI Number | 1245959949
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Entity Type | Individual
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Provider Name | JENNIFER DEARMORE
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Gender | Female
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 4015 WOODLAND HILLS DR
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City | KINGWOOD
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State | TX
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Zip | 77339-0904
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Country | US
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Telephone | 281-641-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 12023 BADLANDS BEND LN
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City | HUMBLE
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State | TX
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Zip | 77346-1294
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Country | US
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Telephone | 936-525-7690
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Fax |
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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 | 103593
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License Number State | TX
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