Provider Demographics
NPI:1205497195
Name:HUFF, JENAI
Entity type:Individual
Prefix:
First Name:JENAI
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 DEEP CREEK DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-6015
Mailing Address - Country:US
Mailing Address - Phone:678-472-5930
Mailing Address - Fax:
Practice Address - Street 1:3867 HOLCOMB BRIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2232
Practice Address - Country:US
Practice Address - Phone:770-446-0911
Practice Address - Fax:844-315-9608
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-22
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist