Provider Demographics
NPI:1568805075
Name:FITCH, JENNIFER ANDREINA (SLP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANDREINA
Last Name:FITCH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17946 DIAMOND PEAK CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4102
Mailing Address - Country:US
Mailing Address - Phone:832-577-4610
Mailing Address - Fax:
Practice Address - Street 1:17946 DIAMOND PEAK CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4102
Practice Address - Country:US
Practice Address - Phone:832-577-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist