Provider Demographics
NPI:1720361595
Name:REJONIS, DENISE DIANE (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:DIANE
Last Name:REJONIS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11621 RENAISSANCE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2683
Mailing Address - Country:US
Mailing Address - Phone:813-500-1840
Mailing Address - Fax:
Practice Address - Street 1:11621 RENAISSANCE VIEW CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2683
Practice Address - Country:US
Practice Address - Phone:813-500-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist