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NPI Code Detail

MEDICARE: JENA MASHOOR AWAD SLP

MEDICARE: JENA MASHOOR AWAD 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
1106S00000XBehavior Technician
2235Z00000XSpeech-Language Pathologist30002339NC

General Provider Information

NPI Number : 1982262036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENA MASHOOR AWAD SLP
Provider Business Mailing Address
First Line : 91 RITTER LN
Second Line :
City : NEWARK
State : DE
Zip : 19711-5174
Country : US
Telephone Number : 302-650-8019
Fax Number :
Provider Business Practice Location Address
First Line : 16409 NORTHCROSS DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-5065
Country : US
Telephone Number : 980-441-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 12/05/2023

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Directions to “ JENA MASHOOR AWAD SLP” Practice Location

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