Provider Demographics
NPI:1407303332
Name:REDDY, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:GREB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, EDS, CCC-SLP
Mailing Address - Street 1:3180 N POINT PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4349
Mailing Address - Country:US
Mailing Address - Phone:866-300-8512
Mailing Address - Fax:800-613-8386
Practice Address - Street 1:3180 N POINT PKWY STE 106
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4349
Practice Address - Country:US
Practice Address - Phone:866-300-8512
Practice Address - Fax:800-613-8386
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist