Provider Demographics
NPI:1568600542
Name:MUSIC, JENNIFER KRISTY (M ED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KRISTY
Last Name:MUSIC
Suffix:
Gender:F
Credentials:M ED CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KRISTY
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:809 8TH ST W
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-3845
Mailing Address - Country:US
Mailing Address - Phone:229-402-0858
Mailing Address - Fax:
Practice Address - Street 1:809 8TH ST W
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-3845
Practice Address - Country:US
Practice Address - Phone:229-402-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006745235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist