Provider Demographics
NPI:1205714797
Name:PALERMO, JENNA MARIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIA
Last Name:PALERMO
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 1:3545 W ATLANTIC BLVD APT 706
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-2577
Mailing Address - Country:US
Mailing Address - Phone:570-926-0535
Mailing Address - Fax:
Practice Address - Street 1:10286 NW 47TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7967
Practice Address - Country:US
Practice Address - Phone:954-665-6717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA23590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist