Provider Demographics
NPI:1861601569
Name:HOVESTADT-MOLLOY, JENNIFER M (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:HOVESTADT-MOLLOY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:PARENTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:417 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1303
Mailing Address - Country:US
Mailing Address - Phone:631-772-8413
Mailing Address - Fax:
Practice Address - Street 1:417 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:EAST YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11967-1303
Practice Address - Country:US
Practice Address - Phone:631-772-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist