Provider Demographics
NPI:1669462495
Name:TRABULSI, JENNIFER MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MARIE
Last Name:TRABULSI
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 1:7609 ELLIOTT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4003
Mailing Address - Country:US
Mailing Address - Phone:919-239-0953
Mailing Address - Fax:
Practice Address - Street 1:7609 ELLIOTT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4003
Practice Address - Country:US
Practice Address - Phone:919-239-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist