Provider Demographics
NPI:1558961060
Name:FEOLA, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FEOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1076
Mailing Address - Country:US
Mailing Address - Phone:732-599-0813
Mailing Address - Fax:
Practice Address - Street 1:862 COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1076
Practice Address - Country:US
Practice Address - Phone:732-599-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist