MEDICARE: JENNIFER L LAMONTAGNE 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	1042	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437116688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L LAMONTAGNE SLP

Provider Business Mailing Address
First Line	:	1909 E RAY RD STE 9-244
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-8724
Country	:	US
Telephone Number	:	480-296-2363
Fax Number	:	480-685-9875

Provider Business Practice Location Address
First Line	:	501 W RAY RD STE 1
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-7284
Country	:	US
Telephone Number	:	480-296-2363
Fax Number	:

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	08/10/2022

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Directions to “ JENNIFER L LAMONTAGNE SLP” Practice Location

Language	Start Address	Practice Location

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