Provider Demographics
NPI:1689025280
Name:FARRANT, JENNIFER (MSED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FARRANT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 E CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-4216
Mailing Address - Country:US
Mailing Address - Phone:757-434-0634
Mailing Address - Fax:813-396-9495
Practice Address - Street 1:1205 E CAYUGA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4216
Practice Address - Country:US
Practice Address - Phone:757-434-0634
Practice Address - Fax:813-396-9495
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL28592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer