Provider Demographics
NPI:1396865796
Name:COX, JENNIFER (AUD, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 HARTFORD TPKE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06247-1320
Mailing Address - Country:US
Mailing Address - Phone:860-455-1404
Mailing Address - Fax:860-455-1396
Practice Address - Street 1:354 HARTFORD TPKE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06247-1320
Practice Address - Country:US
Practice Address - Phone:860-455-1404
Practice Address - Fax:860-455-1396
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000355231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT035500OtherCONNECTICARE
CT004223559OtherMEDICAID