Provider Demographics
NPI:1891729893
Name:NALLEY, JENNIFER SHIMINSKY (AUD CCC-A)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SHIMINSKY
Last Name:NALLEY
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SIMSBURY LANE
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534
Mailing Address - Country:US
Mailing Address - Phone:585-267-7816
Mailing Address - Fax:
Practice Address - Street 1:15 SIMSBURY LANE
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:585-267-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001124231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist