Provider Demographics
NPI:1851901953
Name:JENKINS, SLOAN (AUD)
Entity Type:Individual
Prefix:
First Name:SLOAN
Middle Name:
Last Name:JENKINS
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 1:3300 MAIN STREET
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474
Mailing Address - Country:US
Mailing Address - Phone:979-627-7771
Mailing Address - Fax:979-627-7769
Practice Address - Street 1:3300 MAIN STREET
Practice Address - Street 2:SUITE 1C
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474
Practice Address - Country:US
Practice Address - Phone:979-627-7771
Practice Address - Fax:979-627-7769
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81139231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist