Provider Demographics
NPI:1124890249
Name:MARTINEZ, JENNIFER SCHWEEN (SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHWEEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 W DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2070
Mailing Address - Country:US
Mailing Address - Phone:214-642-5013
Mailing Address - Fax:
Practice Address - Street 1:1616 WELLERMAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7427
Practice Address - Country:US
Practice Address - Phone:318-387-2577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7450235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist