MEDICARE: JENNIFER JO LAHNA M.A., CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP - 6019	OH

General Provider Information

NPI Number	:	1093167504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JO LAHNA M.A., CCC/SLP

Provider Business Mailing Address
First Line	:	1207 CAMBRIDGE RD
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-2742
Country	:	US
Telephone Number	:	740-622-1901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1203 CAMBRIDGE RD
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-2741
Country	:	US
Telephone Number	:	740-622-5514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	07/08/2016

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