Provider Demographics
NPI:1568930824
Name:LUJAN, JENNY ANNETTE (SLPA)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:ANNETTE
Last Name:LUJAN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 BROWN ST STE A-1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4736
Mailing Address - Country:US
Mailing Address - Phone:915-600-2069
Mailing Address - Fax:915-500-1875
Practice Address - Street 1:1527 BROWN ST STE A-1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4736
Practice Address - Country:US
Practice Address - Phone:915-600-2069
Practice Address - Fax:915-500-1875
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist