Provider Demographics
NPI:1477728137
Name:SMITH, JENNIFER BRUSER (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRUSER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 PROVIDENCE PARK
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4680
Mailing Address - Country:US
Mailing Address - Phone:205-982-7220
Mailing Address - Fax:205-982-7228
Practice Address - Street 1:2001 PROVIDENCE PARK
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4680
Practice Address - Country:US
Practice Address - Phone:205-982-7220
Practice Address - Fax:205-982-7228
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0991A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter