MEDICARE: JENNA MARCHETTI 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	2202007072	VA

General Provider Information

NPI Number	:	1477995025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MARCHETTI M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	4110 E PARHAM RD
Second Line	:	SUITE 101
City	:	HENRICO
State	:	VA
Zip	:	23228-0018
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 E PARHAM RD
Second Line	:	SUITE 101
City	:	HENRICO
State	:	VA
Zip	:	23228-0018
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:

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

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	07/21/2017

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Directions to “ JENNA MARCHETTI M.S. CCC-SLP” Practice Location

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