Provider Demographics
NPI:1013461532
Name:MARTIN, JENNIFER (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MARTIN
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 1:377 PLANTATION ST
Mailing Address - Street 2:AUDIOLOGY (126)
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2300
Mailing Address - Country:US
Mailing Address - Phone:413-584-4040
Mailing Address - Fax:
Practice Address - Street 1:377 PLANTATION ST
Practice Address - Street 2:AUDIOLOGY (126)
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2300
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist