Provider Demographics
NPI:1932750825
Name:SILVERSTON, JENNIFER SUZANNE
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:SILVERSTON
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 1:46 MOORLAND DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1112
Mailing Address - Country:US
Mailing Address - Phone:313-515-9718
Mailing Address - Fax:
Practice Address - Street 1:46 MOORLAND DR
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE SHORES
Practice Address - State:MI
Practice Address - Zip Code:48236-1112
Practice Address - Country:US
Practice Address - Phone:313-515-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer