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NPI Code Detail

MEDICARE: JENNA RAPHEL

MEDICARE:   JENNA  RAPHEL
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 Pathologist

General Provider Information

NPI Number : 1811700313
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA RAPHEL
Provider Business Mailing Address
First Line : 22 MOUNT CARMEL WAY UNIT 372
Second Line :
City : WORCESTER
State : MA
Zip : 01605-4155
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 324 CLARK ST
Second Line :
City : WORCESTER
State : MA
Zip : 01606-1214
Country : US
Telephone Number : 508-752-3969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2025
Last Update Date : 01/29/2025

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Directions to “ JENNA RAPHEL ” Practice Location

Language Start Address Practice Location
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