Provider Demographics
NPI:1063131225
Name:WESTMORELAND, JENNIFER ALCORN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ALCORN
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W BLOXHAM ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2310
Mailing Address - Country:US
Mailing Address - Phone:850-644-9392
Mailing Address - Fax:
Practice Address - Street 1:201 W BLOXHAM ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2310
Practice Address - Country:US
Practice Address - Phone:850-644-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist