Jenifer Leigh Baker, MCD, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Centreville, VA
NPI 1750623740 · NPPES record last updated Mar 18, 2013
Key facts
- NPI
- 1750623740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2202006929 (VA)
- Practice address
- 13890 Braddock Rd
Suite 205
Centreville, VA 20121-2435 - Phone
- (540) 720-2261
- Fax
- (540) 720-5660
- NPI assigned
- Mar 18, 2013
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202006929 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202006929 | VA | Yes |
Addresses
Primary practice location
13890 Braddock Rd
Suite 205
Centreville, VA 20121-2435
Mailing address
2765 Jefferson Davis Hwy
Suite 209
Stafford, VA 22554-8331
Phone (540) 720-2261
Other names
- Jenifer Leigh Gordon
Other providers in Centreville, VA
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- Edward Seung-Won Baek
- Christina Ball
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- Mary Elizabeth Baron
All providers in Centreville, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.