Provider Demographics
NPI:1932414208
Name:BROWN, JENNIFER EILEEN (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:EILEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 HIGHWAY 6 S STE 211
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4022
Mailing Address - Country:US
Mailing Address - Phone:832-321-3655
Mailing Address - Fax:832-321-3675
Practice Address - Street 1:810 HIGHWAY 6 S STE 211
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4022
Practice Address - Country:US
Practice Address - Phone:832-321-3655
Practice Address - Fax:832-321-3675
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX455423641OtherTRICARE-HUMANA MILITARY
TX798442OtherOPTUM HEALTH
TX8156743OtherMEDICARE PART B
TX0084XLOtherBLUECROSS BLUE SHIELD OF TEXAS
TX304662501Medicaid
TXTXB156743OtherMEDICARE PART B INDIVIDUAL