Provider Demographics
NPI:1407136922
Name:SINCLAIR, JENNIFER J (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:J
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7346
Mailing Address - Country:US
Mailing Address - Phone:716-634-2739
Mailing Address - Fax:
Practice Address - Street 1:5150 OLD GOODRICH RD
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-2406
Practice Address - Country:US
Practice Address - Phone:716-407-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3866-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist