Provider Demographics
NPI:1467846808
Name:GRECA, JENNIFER R (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:R
Last Name:GRECA
Suffix:
Gender:F
Credentials:MA CCC-SLP
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Mailing Address - Street 1:4343 CONCOURSE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-8672
Mailing Address - Country:US
Mailing Address - Phone:734-677-0200
Mailing Address - Fax:734-677-3310
Practice Address - Street 1:4343 CONCOURSE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-8672
Practice Address - Country:US
Practice Address - Phone:734-677-0200
Practice Address - Fax:734-677-3310
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI7101001686235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist