Provider Demographics
NPI:1922052521
Name:REEVES, JENNIFER E (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:REEVES
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 1:8501 N 50TH ST
Mailing Address - Street 2:APT 706
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-6100
Mailing Address - Country:US
Mailing Address - Phone:813-404-3536
Mailing Address - Fax:
Practice Address - Street 1:14540 CORTEZ BLVD
Practice Address - Street 2:BROOKSVILLE VA CBOC
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6056
Practice Address - Country:US
Practice Address - Phone:352-597-8287
Practice Address - Fax:352-597-3272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1326231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist