Provider Demographics
NPI:1164682936
Name:JENNINGS, CINDY (MSCCCSLP)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 SUMMERHILL RD STE 14
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3542
Mailing Address - Country:US
Mailing Address - Phone:903-792-3003
Mailing Address - Fax:903-792-3003
Practice Address - Street 1:3505 SUMMERHILL RD STE 14
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3542
Practice Address - Country:US
Practice Address - Phone:903-792-3003
Practice Address - Fax:903-792-3003
Is Sole Proprietor?:No
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist