Provider Demographics
NPI:1003086406
Name:RAMSEY, JENNA MARIE (BS)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 E DRAGOON AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-3820
Mailing Address - Country:US
Mailing Address - Phone:480-330-5101
Mailing Address - Fax:
Practice Address - Street 1:4925 E INGRAM ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-3314
Practice Address - Country:US
Practice Address - Phone:480-472-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ397-7484235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist