Provider Demographics
NPI:1831223106
Name:ZMUDA, JENNIFER L (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:ZMUDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6098 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-9719
Mailing Address - Country:US
Mailing Address - Phone:513-524-0046
Mailing Address - Fax:
Practice Address - Street 1:6098 BROWN RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-9719
Practice Address - Country:US
Practice Address - Phone:513-524-0046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP5824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist