Provider Demographics
NPI:1922389642
Name:MINEHART, JENNIFER ANNE (MA-CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:MINEHART
Suffix:
Gender:F
Credentials:MA-CCC-SLP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:LAMPING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3168
Mailing Address - Country:US
Mailing Address - Phone:215-630-0123
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PLZ
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44555-0001
Practice Address - Country:US
Practice Address - Phone:330-941-1950
Practice Address - Fax:330-941-4650
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-8538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist