Provider Demographics
NPI:1790006096
Name:SELLERS, JENNA HOFFMAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:HOFFMAN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N 2ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6078
Mailing Address - Country:US
Mailing Address - Phone:208-489-4999
Mailing Address - Fax:208-489-4075
Practice Address - Street 1:510 N 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6078
Practice Address - Country:US
Practice Address - Phone:208-489-4999
Practice Address - Fax:208-489-4075
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-1565231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist