Provider Demographics
NPI:1790075067
Name:BEBEE, JENNIFER ASHLEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:BEBEE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ASHLEY
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2139 N 12TH ST
Mailing Address - Street 2:STE 4
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2910
Mailing Address - Country:US
Mailing Address - Phone:970-270-2486
Mailing Address - Fax:
Practice Address - Street 1:2139 N 12TH ST STE 4
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2910
Practice Address - Country:US
Practice Address - Phone:970-249-6968
Practice Address - Fax:970-549-4658
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO614231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57331375Medicaid