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General NPI Number Information
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NPI Number | 1982971842
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Entity Type | Individual
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Provider Name | JENNIFER LYNN MARTIN MA CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 7232 SW 39TH TER
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City | MIAMI
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State | FL
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Zip | 33155-6624
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Country | US
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Telephone | 786-409-3254
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 277
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City | SILVER SPRINGS
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State | FL
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Zip | 34489-0277
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Country | US
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Telephone | 785-546-2599
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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 | SLP-1267
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA11884
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License Number State | FL
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