Provider Demographics
NPI:1710718242
Name:WOLF, JENNIFER M (SLPA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:WOLF
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:PLOTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8129 LIN OAK WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2604
Mailing Address - Country:US
Mailing Address - Phone:916-597-5991
Mailing Address - Fax:
Practice Address - Street 1:730 SUNRISE AVE STE 120
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4549
Practice Address - Country:US
Practice Address - Phone:916-436-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84652355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant