Provider Demographics
NPI:1902096217
Name:MEYER, JENA MICHELLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JENA
Middle Name:MICHELLE
Last Name:MEYER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:JENA
Other - Middle Name:MICHELLE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:1505 250TH ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-8200
Mailing Address - Country:US
Mailing Address - Phone:913-231-9393
Mailing Address - Fax:
Practice Address - Street 1:201 S 4TH ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2402
Practice Address - Country:US
Practice Address - Phone:785-742-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1263235Z00000X
MO2008007856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist