MEDICARE: MRS. JENNIFER RENEE LAUBAUGH M.S., 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	SA7788	FL

General Provider Information

NPI Number	:	1194850487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER RENEE LAUBAUGH M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	1178A GILMORE DR
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-6762
Country	:	US
Telephone Number	:	305-735-3526
Fax Number	:

Provider Business Practice Location Address
First Line	:	5220 COLLEGE RD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-4302
Country	:	US
Telephone Number	:	305-294-1089
Fax Number	:

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

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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