Provider Demographics
NPI:1700129996
Name:HERRING, JENNIFER STEWART (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:STEWART
Last Name:HERRING
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:NICOLE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:PO BOX 828
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8144
Mailing Address - Country:US
Mailing Address - Phone:972-562-0190
Mailing Address - Fax:
Practice Address - Street 1:1416 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1806
Practice Address - Country:US
Practice Address - Phone:972-359-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist