Provider Demographics
NPI:1003935206
Name:KINCAID, JENNIFER (PHD, CCC-A, FAAA)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:KINCAID
Suffix:
Gender:F
Credentials:PHD, CCC-A, FAAA
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MCCATHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3615 E JOPPA RD STE 210
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3386
Mailing Address - Country:US
Mailing Address - Phone:410-944-3100
Mailing Address - Fax:866-694-3527
Practice Address - Street 1:9338 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2805
Practice Address - Country:US
Practice Address - Phone:410-313-9100
Practice Address - Fax:866-694-3527
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01084231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist