Provider Demographics
NPI:1730960543
Name:RODENHEISER, JENSEN KATE (CCC-SLP, CDP)
Entity type:Individual
Prefix:
First Name:JENSEN
Middle Name:KATE
Last Name:RODENHEISER
Suffix:
Gender:F
Credentials:CCC-SLP, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 PRESS PL APT 363
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2083
Mailing Address - Country:US
Mailing Address - Phone:845-238-9334
Mailing Address - Fax:
Practice Address - Street 1:4206 STAMMER PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3302
Practice Address - Country:US
Practice Address - Phone:615-527-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist