Provider Demographics
NPI:1598013443
Name:DENNIS, JENNIFER LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:STORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1310 E BELTLINE AVE SE STE 230
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4304
Mailing Address - Country:US
Mailing Address - Phone:616-288-3732
Mailing Address - Fax:616-288-9857
Practice Address - Street 1:1310 E BELTLINE AVE SE STE 230
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506
Practice Address - Country:US
Practice Address - Phone:616-288-3732
Practice Address - Fax:616-288-9857
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist