Provider Demographics
NPI:1548578073
Name:READ, JENNIFER (MS, CCC-SLP/TSLD)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:READ
Suffix:
Gender:F
Credentials:MS, CCC-SLP/TSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 83RD ST
Mailing Address - Street 2:1D
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7154
Mailing Address - Country:US
Mailing Address - Phone:917-701-1247
Mailing Address - Fax:
Practice Address - Street 1:4069 94TH ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1770
Practice Address - Country:US
Practice Address - Phone:718-779-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106102-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist