Jenna Michele Wollerman, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012265 Issued in GA

Practice address

311 Cooper Road
Grayson, GA 30017

Phone

(678) 205-5437

NPI assigned

Sep 1, 2022

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nix Therapy Services Inc

  dba TLC Therapy Services

  • Speech-Language Pathologist
  • Buford, GA
  • NPI 1831896489
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1780304428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SOMERSET CT",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300161768",
            "telephone_number": "201-937-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 COOPER ROAD",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "30017",
            "telephone_number": "678-205-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLERMAN",
        "first_name": "JENNA",
        "middle_name": "MICHELE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Williams, RPH
• Larresia Hairston Williamson, RN, MSN, FNP-BC
• Erin Destiny Wilson
• Ramona Wimberly
• Jean Winston, M.A. CCC-SLP
• Brian Woodard, LPN
• Wooten Healthcare Services
• Antoinette Wooten
• Xavier Eye Care
• Freshta Zaher

• Speech-Language Pathologist in Grayson, GA
• Providers in Grayson, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.