Provider Demographics
NPI:1700342672
Name:BEAUDET, JENNIFER ZIMM
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ZIMM
Last Name:BEAUDET
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 1:8408 LAUREL LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-9794
Mailing Address - Country:US
Mailing Address - Phone:239-273-8120
Mailing Address - Fax:
Practice Address - Street 1:8408 LAUREL LAKES BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9794
Practice Address - Country:US
Practice Address - Phone:239-273-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist