MEDICARE: MRS. JENNIFER M DITGES 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	SA 10304	FL
2	3747P1801X	Personal Care Attendant

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	:	1932421054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER M DITGES M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	9356 RIVER PINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-4929
Country	:	US
Telephone Number	:	904-588-8285
Fax Number	:

Provider Business Practice Location Address
First Line	:	9356 RIVER PINE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-4929
Country	:	US
Telephone Number	:	904-588-8285
Fax Number	:

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

Provider Enumeration Date	:	02/16/2010
Last Update Date	:	12/21/2018

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Directions to “ MRS. JENNIFER M DITGES M.S. CCC-SLP” Practice Location

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