Provider Demographics
NPI:1851506612
Name:SCHNEIDER, JENNIFER JO (SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JO
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-1444
Mailing Address - Country:US
Mailing Address - Phone:620-381-1265
Mailing Address - Fax:
Practice Address - Street 1:422 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-1444
Practice Address - Country:US
Practice Address - Phone:620-381-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist