Provider Demographics
NPI:1952623308
Name:JARZOMBEK, CHANTAL H (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:H
Last Name:JARZOMBEK
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:PO BOX 2679
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299
Mailing Address - Country:US
Mailing Address - Phone:210-616-0121
Mailing Address - Fax:210-614-1003
Practice Address - Street 1:19026 STONE OAK PARKWAY
Practice Address - Street 2:STE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-545-0404
Practice Address - Fax:210-614-1003
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist