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NPI 1538094776

NPI 1538094776 : MRS. JENNA MARIA MARCOPOLI : LIVONIA, MI

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General NPI Number Information
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    NPI Number           |    1538094776
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    Entity Type          |    Individual 
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    Provider Name        |    MRS. JENNA MARIA MARCOPOLI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/17/2026
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    Last Update Date     |    06/17/2026
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Provider Practice Location Address
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    Address Line         |    36475 FIVE MILE RD 
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    City                 |    LIVONIA
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    State                |    MI
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    Zip                  |    48154-1971
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    Country              |    US
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    Telephone            |    734-655-4800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    266 W 14 MILE RD APT 2 
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    City                 |    CLAWSON
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    State                |    MI
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    Zip                  |    48017-3101
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    Country              |    US
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    Telephone            |    
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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       |    7152001372
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    License Number State |    MI
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