Provider Demographics
NPI:1639688195
Name:JENNINGS, LORINDA LEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORINDA
Middle Name:LEE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-1060
Mailing Address - Country:US
Mailing Address - Phone:217-532-6994
Mailing Address - Fax:
Practice Address - Street 1:1035 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-1060
Practice Address - Country:US
Practice Address - Phone:217-532-6994
Practice Address - Fax:217-532-6994
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004127235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty