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1982971842 NPI number — JENNIFER LYNN MARTIN MA CCC/SLP

NPI Number: 1982971842
Health Care Provider/Practitioner: JENNIFER LYNN MARTIN MA CCC/SLP

Information about “1982971842” NPI (JENNIFER LYNN MARTIN MA CCC/SLP) exists in 1982971842 in HTML format HTML  |  1982971842 in plain Text format TXT  |  1982971842 in PDF (Portable Document Format) PDF  |  1982971842 in an XML format XML  formats.

NPI Number : 1982971842 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982971842",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTIN",
    "FirstName": "JENNIFER",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA CCC/SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JACKSON",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MA CCC/SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 277",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SILVER SPRINGS",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34489-0277",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "785-546-2599",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7232 SW 39TH TER",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIAMI",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33155-6624",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-409-3254",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/21/2011",
    "LastUpdateDate": "04/06/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SLP-1267",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SA11884",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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