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NPI Code Detail

MEDICARE: MRS. JENNIFER SUSANNE QUINALTY M.S., CCC-SLP

MEDICARE: MRS. JENNIFER SUSANNE QUINALTY 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
1235Z00000XSpeech-Language PathologistSP#1933AR

General Provider Information

NPI Number : 1427086099
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER SUSANNE QUINALTY M.S., CCC-SLP
Provider Business Mailing Address
First Line : 3703 SW KESTREL DR
Second Line :
City : BENTONVILLE
State : AR
Zip : 72712-8405
Country : US
Telephone Number : 479-644-1267
Fax Number :
Provider Business Practice Location Address
First Line : 1000 W POPLAR ST
Second Line :
City : ROGERS
State : AR
Zip : 72756-4242
Country : US
Telephone Number : 479-621-8500
Fax Number : 479-621-8506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. JENNIFER SUSANNE QUINALTY M.S., CCC-SLP” Practice Location

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