Provider Demographics
NPI:1205345709
Name:FERZOCO, JENNIFER EDITH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:EDITH
Last Name:FERZOCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:741 KENILWORTH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3874
Mailing Address - Country:US
Mailing Address - Phone:1704-523-8027
Mailing Address - Fax:704-523-8031
Practice Address - Street 1:741 KENILWORTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3874
Practice Address - Country:US
Practice Address - Phone:704-523-8027
Practice Address - Fax:704-523-8031
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist