Provider Demographics
NPI:1831582485
Name:HOATS, JENNIFER (MS, CCC-SLP, CBIS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HOATS
Suffix:
Gender:F
Credentials:MS, CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 2102
Mailing Address - Street 2:
Mailing Address - City:ZION GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17985-9734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:PA
Practice Address - Zip Code:17976-1332
Practice Address - Country:US
Practice Address - Phone:570-462-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist