Jenna Perez, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Leon Valley, TX

NPI 1093433153 · NPPES record last updated Aug 16, 2022

Key facts

NPI
1093433153
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
110376 (TX)
Practice address
5651 Grissom Rd
Leon Valley, TX 78238-2220
Phone
(210) 397-8158
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
110376TXMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 110376 TX Yes

Addresses

Primary practice location

5651 Grissom Rd
Leon Valley, TX 78238-2220

Mailing address

5651 Grissom Rd
Leon Valley, TX 78238-2220
Phone (210) 397-8158

Other providers in Leon Valley, TX

All providers in Leon Valley, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.