Provider Demographics
NPI:1578033932
Name:STEINBRENNER, JENNA (SLP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:STEINBRENNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:TOLLEFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-4940
Mailing Address - Country:US
Mailing Address - Phone:734-634-9175
Mailing Address - Fax:
Practice Address - Street 1:8254 118TH AVENUE NORTH
Practice Address - Street 2:SUITE 100
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5027
Practice Address - Country:US
Practice Address - Phone:727-541-5304
Practice Address - Fax:727-546-8527
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18340235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist