Provider Demographics
NPI:1346890274
Name:VINCENT, JENNA ROSE (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ROSE
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 US HWY 68 AND 68
Mailing Address - Street 2:THERAPY DEPT
Mailing Address - City:RIPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45167
Mailing Address - Country:US
Mailing Address - Phone:937-392-4318
Mailing Address - Fax:937-392-1622
Practice Address - Street 1:5280 US HWY 68 AND 68
Practice Address - Street 2:THERAPY DEPT
Practice Address - City:RIPLEY
Practice Address - State:OH
Practice Address - Zip Code:45167
Practice Address - Country:US
Practice Address - Phone:937-392-4318
Practice Address - Fax:937-392-1622
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist