Provider Demographics
NPI:1518116367
Name:REEDER, JENNIFER REGNERY (MS CCC-SLP CERT AVT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:REGNERY
Last Name:REEDER
Suffix:
Gender:F
Credentials:MS CCC-SLP CERT AVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3668 SAN ANSELINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2701
Mailing Address - Country:US
Mailing Address - Phone:562-212-9625
Mailing Address - Fax:
Practice Address - Street 1:3840 WOODRUFF AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2143
Practice Address - Country:US
Practice Address - Phone:562-354-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist