Provider Demographics
NPI:1568894889
Name:AGRONT, JENNIFER (THL)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AGRONT
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 CARR 64 # VILLAS
Mailing Address - Street 2:APT. 124
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6033
Mailing Address - Country:US
Mailing Address - Phone:787-420-8983
Mailing Address - Fax:
Practice Address - Street 1:CARR. # 2 KM 79.4 AVE. MIRAMAR # 1141
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0025422355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant