Provider Demographics
NPI:1538403316
Name:JASPER, JENNIFER M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:JASPER
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 1:249 MATTITY RD
Mailing Address - Street 2:
Mailing Address - City:N SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-9520
Mailing Address - Country:US
Mailing Address - Phone:401-356-1954
Mailing Address - Fax:
Practice Address - Street 1:249 MATTITY RD
Practice Address - Street 2:
Practice Address - City:N SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-9520
Practice Address - Country:US
Practice Address - Phone:401-356-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00259-P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist