Provider Demographics
NPI:1154785459
Name:GIBBONS, JENNIFER SNOW (AUD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SNOW
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:SNOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:1399 S HAVANA ST
Practice Address - Street 2:102
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4020
Practice Address - Country:US
Practice Address - Phone:303-337-9699
Practice Address - Fax:303-337-9546
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO756231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist