Provider Demographics
NPI:1710221585
Name:ADAMSON, JENNIFER ANN (AUD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5170 GRAHAM DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1040
Mailing Address - Country:US
Mailing Address - Phone:330-749-0560
Mailing Address - Fax:
Practice Address - Street 1:5170 GRAHAM DR
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1040
Practice Address - Country:US
Practice Address - Phone:330-749-0560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01815231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA.01815OtherOHIO LICENSE