Provider Demographics
NPI:1326079112
Name:CARNER, JENNIFER L (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CARNER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIS, CHAOC
Mailing Address - Street 1:2222 BAKEWELL ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-1208
Mailing Address - Country:US
Mailing Address - Phone:419-671-7700
Mailing Address - Fax:
Practice Address - Street 1:2222 BAKEWELL ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-1208
Practice Address - Country:US
Practice Address - Phone:419-671-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP13239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2674OtherHA DEALERS AND FITTERS