Provider Demographics
NPI:1396063335
Name:HOWE, JENNIFER JEFFERSON (SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JEFFERSON
Last Name:HOWE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 N BOND ST
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0984
Mailing Address - Country:US
Mailing Address - Phone:928-254-3086
Mailing Address - Fax:
Practice Address - Street 1:6701 W UNION HILLS DR STE 2
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-439-7400
Practice Address - Fax:602-439-2011
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-15
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP8417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist