Provider Demographics
NPI:1902168479
Name:SCHAA, JENNA LISA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:LISA
Last Name:SCHAA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LISA
Other - Last Name:HAMBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4328 E HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5472
Mailing Address - Country:US
Mailing Address - Phone:520-508-5252
Mailing Address - Fax:
Practice Address - Street 1:10399 E TURKEY CREEK RD
Practice Address - Street 2:
Practice Address - City:PEARCE
Practice Address - State:AZ
Practice Address - Zip Code:85625-6165
Practice Address - Country:US
Practice Address - Phone:520-780-9629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP7790235Z00000X
AZSLP7790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP7790OtherSTATE SPEECH LANGUAGE PATHOLOGIST LICENSE