Provider Demographics
NPI:1326499146
Name:SEGANTI, JENNA R (MS SLP, TSSLD)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:R
Last Name:SEGANTI
Suffix:
Gender:F
Credentials:MS SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 KITTIWAKE CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-5212
Mailing Address - Country:US
Mailing Address - Phone:561-558-6730
Mailing Address - Fax:
Practice Address - Street 1:175 WOLF HILL RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1340
Practice Address - Country:US
Practice Address - Phone:631-423-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist