Provider Demographics
NPI:1386226256
Name:SAUNDERS, JENIFER DEAS
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:DEAS
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 LAKES DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-6240
Mailing Address - Country:US
Mailing Address - Phone:770-289-7530
Mailing Address - Fax:
Practice Address - Street 1:253 LAKES DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6240
Practice Address - Country:US
Practice Address - Phone:770-289-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency