Provider Demographics
NPI:1902286024
Name:GARRISON, JENNIFER H (MA,, SLP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:H
Last Name:GARRISON
Suffix:
Gender:F
Credentials:MA,, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 CODY ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4332
Mailing Address - Country:US
Mailing Address - Phone:913-530-1737
Mailing Address - Fax:
Practice Address - Street 1:7106 CODY ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4332
Practice Address - Country:US
Practice Address - Phone:913-530-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-3022235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist