MEDICARE: JENNIFER ZNOTENS 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	2202001988	VA

General Provider Information

NPI Number	:	1326401084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ZNOTENS M,A., CCC-SLP

Provider Business Mailing Address
First Line	:	7401 BEAUFONT SPRING DR
Second Line	:	SUITE 205
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5520
Country	:	US
Telephone Number	:	804-272-0114
Fax Number	:	804-272-1125

Provider Business Practice Location Address
First Line	:	7401 BEAUFONT SPRING DR
Second Line	:	SUITE 205
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-5520
Country	:	US
Telephone Number	:	804-272-0114
Fax Number	:	804-272-1125

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

Provider Enumeration Date	:	03/31/2016
Last Update Date	:	03/31/2016

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