Provider Demographics
NPI:1114038940
Name:TINSLEY, JENNIFER KAREN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KAREN
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15315 HARROWGATE WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4700
Mailing Address - Country:US
Mailing Address - Phone:407-340-2701
Mailing Address - Fax:
Practice Address - Street 1:10125 W COLONIAL DR
Practice Address - Street 2:SUITE 216
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4211
Practice Address - Country:US
Practice Address - Phone:407-295-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 3922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist