Provider Demographics
NPI:1477966497
Name:HAGGARD, JENNIFER (SLP-ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 S 47TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-2434
Mailing Address - Country:US
Mailing Address - Phone:512-797-0374
Mailing Address - Fax:
Practice Address - Street 1:220 175TH ST S
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8703
Practice Address - Country:US
Practice Address - Phone:253-800-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA614533442355S0801X
TX361642355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant