Provider Demographics
NPI:1649468356
Name:JUENGLING-SUDKAMP, JENIFER (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:
Last Name:JUENGLING-SUDKAMP
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:DR
Other - First Name:JENIFER
Other - Middle Name:
Other - Last Name:JUENGLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, CCC-SLP
Mailing Address - Street 1:305 UNION CT
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-5962
Mailing Address - Country:US
Mailing Address - Phone:504-491-4794
Mailing Address - Fax:
Practice Address - Street 1:202 MCALISTER EXTENSION
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118
Practice Address - Country:US
Practice Address - Phone:504-864-2129
Practice Address - Fax:504-864-2130
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist