Provider Demographics
NPI:1669780680
Name:DONOVAN, JENNIFER ELIZABETH (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:DONOVAN
Suffix:
Gender:
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:ELIZABETH
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-1253
Mailing Address - Country:US
Mailing Address - Phone:585-392-1000
Mailing Address - Fax:585-392-1065
Practice Address - Street 1:225 WEST AVE
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-1253
Practice Address - Country:US
Practice Address - Phone:585-392-1000
Practice Address - Fax:585-392-1065
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008361-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist