Provider Demographics
NPI:1275103707
Name:AGUILAR, JENIFER MARIE (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:MARIE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 MISTY SPRING LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4295
Mailing Address - Country:US
Mailing Address - Phone:281-923-6860
Mailing Address - Fax:
Practice Address - Street 1:6619 MISTY SPRING LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4295
Practice Address - Country:US
Practice Address - Phone:281-923-6860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist