Provider Demographics
NPI:1205650041
Name:SPINELLI, JENNIFER SARAH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SARAH
Last Name:SPINELLI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 WINDEMERE CIR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-9588
Mailing Address - Country:US
Mailing Address - Phone:570-687-8537
Mailing Address - Fax:
Practice Address - Street 1:1005 WINDEMERE CIR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:PA
Practice Address - Zip Code:18414-9588
Practice Address - Country:US
Practice Address - Phone:570-687-8537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLO10498235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist