Provider Demographics
NPI:1225397243
Name:FRIEDRICH, JENNIFER LEIGH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEIGH
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:25102 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-3409
Mailing Address - Country:US
Mailing Address - Phone:281-734-9595
Mailing Address - Fax:832-534-4122
Practice Address - Street 1:25102 BRIDGEWATER DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-3409
Practice Address - Country:US
Practice Address - Phone:281-734-9595
Practice Address - Fax:832-534-4122
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24762235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist