Provider Demographics
NPI:1376625483
Name:MCGLOTHLIN, JENNIFER H (MS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:H
Last Name:MCGLOTHLIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1966 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7298
Mailing Address - Country:US
Mailing Address - Phone:972-883-3660
Mailing Address - Fax:972-883-3622
Practice Address - Street 1:2895 FACILITIES WAY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-0034
Practice Address - Country:US
Practice Address - Phone:972-883-3660
Practice Address - Fax:972-883-3622
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172827101Medicaid
TX87447TOtherBLUE CROSS BLUE SHIELD
TX87447TOtherBLUE CROSS BLUE SHIELD