Provider Demographics
NPI:1629559331
Name:RAMATICI GLAHOLT, JENNEA (SLPA)
Entity Type:Individual
Prefix:
First Name:JENNEA
Middle Name:
Last Name:RAMATICI GLAHOLT
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 1:315 E COTATI AVE STE F
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-7801
Mailing Address - Country:US
Mailing Address - Phone:707-326-3548
Mailing Address - Fax:
Practice Address - Street 1:315 E COTATI AVE STE F
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-7801
Practice Address - Country:US
Practice Address - Phone:707-326-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43962355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant