Provider Demographics
NPI:1083886550
Name:SCHRYER, JENNIFER R (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:SCHRYER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MOUNT SOPRIS DR
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4606
Mailing Address - Country:US
Mailing Address - Phone:720-352-9652
Mailing Address - Fax:
Practice Address - Street 1:1100 MOUNT SOPRIS DR
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601
Practice Address - Country:US
Practice Address - Phone:720-352-9652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO340231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00572861Medicaid
CO340OtherDIVISION OF REGISTRATION, AUDIOLOGIST