Provider Demographics
NPI:1760249023
Name:LEVY, JENNIE H (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:H
Last Name:LEVY
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 1:4545 BISSONNET ST STE 250
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3007
Mailing Address - Country:US
Mailing Address - Phone:713-669-8635
Mailing Address - Fax:713-218-7593
Practice Address - Street 1:4545 BISSONNET ST STE 250
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3007
Practice Address - Country:US
Practice Address - Phone:713-669-8635
Practice Address - Fax:713-218-7593
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist