Provider Demographics
NPI:1124636410
Name:JENNINGS, PENNY S (CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:S
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 18TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2650
Mailing Address - Country:US
Mailing Address - Phone:360-459-1823
Mailing Address - Fax:
Practice Address - Street 1:1800 7 OAKS RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7300
Practice Address - Country:US
Practice Address - Phone:360-412-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist