Provider Demographics
NPI:1568878213
Name:PATTERSON, JENNA LYNN (MSCCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MSCCC-SLP/L
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LYNN
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:238 S CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62681-1465
Mailing Address - Country:US
Mailing Address - Phone:217-322-4321
Mailing Address - Fax:217-322-6459
Practice Address - Street 1:238 S CONGRESS ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-1465
Practice Address - Country:US
Practice Address - Phone:217-322-4321
Practice Address - Fax:217-322-6459
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist