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General NPI Number Information
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NPI Number | 1790864965
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Entity Type | Individual
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Provider Name | JENNIFER L. FANIEL SLP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 3801 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2758
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Country | US
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Telephone | 877-852-0246
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Fax | 877-904-5749
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Provider Business Mailing Address
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Address Line | 216 BEHRING WAY
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City | JUPITER
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State | FL
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Zip | 33458-1609
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Country | US
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Telephone | 877-852-0246
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Fax | 877-904-5749
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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 |
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License Number State |
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