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General NPI Number Information
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NPI Number | 1891252920
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Entity Type | Individual
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Provider Name | JENNIFER ALLEN M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 9747 BROKEN BOW RD
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City | DALLAS
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State | TX
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Zip | 75238-2507
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Country | US
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Telephone | 214-952-2684
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Fax |
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Provider Business Mailing Address
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Address Line | 9942 EDGECLIFF CIR
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City | DALLAS
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State | TX
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Zip | 75238-2626
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Country | US
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Telephone | 214-395-4042
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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 | 103190
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License Number State | TX
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