Jenna Taylor
Individual provider Active NPI Speech-Language Pathologist · Graceville, FL
NPI 1861019093 · NPPES record last updated Jul 4, 2020
Key facts
- NPI
- 1861019093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SA14277 (FL)
- Practice address
- 1083 Sanders Ave
Graceville, FL 32440-1854 - Phone
- (850) 263-4447
- NPI assigned
- Jul 4, 2020
- 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 |
|---|---|---|---|
| SA14277 | FL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA14277 | FL | Yes |
Addresses
Primary practice location
1083 Sanders Ave
Graceville, FL 32440-1854
Mailing address
3543 Seminole LN
Bonifay, FL 32425-5817
Phone (850) 849-0389
Other providers in Graceville, FL
- Southern Home Respiratory of FL
- Danny W Spears
- Sunshine Behavioral Medicine Inc
- Sweet T Legacies, LLC
- Donald Kerry Taylor
- Terry E Nichols DMD PA
- Karess Angelica Trawick
- Nicholas Anthony Varcadipane
- Wellbody Physical Therapy LLC
- Jerrai Rochelle Young
All providers in Graceville, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2020. 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.