Provider Demographics
NPI:1811211873
Name:CORA, JENNIFER D (MS, CCC-SLP, PHL)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:D
Last Name:CORA
Suffix:
Gender:F
Credentials:MS, CCC-SLP, PHL
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:D
Other - Last Name:NOBLES HARRING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP, PHL
Mailing Address - Street 1:242 LA SERRANIA
Mailing Address - Street 2:CALLE AZUCENA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1808
Mailing Address - Country:US
Mailing Address - Phone:787-653-9130
Mailing Address - Fax:
Practice Address - Street 1:242 LA SERRANIA
Practice Address - Street 2:CALLE AZUCENA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1808
Practice Address - Country:US
Practice Address - Phone:787-653-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist