Provider Demographics
NPI:1669856597
Name:LINGVAI, JENNIFER (MED, CCC-A)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LINGVAI
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13059 E PEAKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6511
Mailing Address - Country:US
Mailing Address - Phone:303-264-2439
Mailing Address - Fax:
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:STE 160
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1669
Practice Address - Country:US
Practice Address - Phone:303-264-2439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51735231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist