Provider Demographics
NPI:1154819803
Name:SPERO, JENNY
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:SPERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 STOREY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-1848
Mailing Address - Country:US
Mailing Address - Phone:978-462-6250
Mailing Address - Fax:
Practice Address - Street 1:21 STOREY AVE STE 1
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-1848
Practice Address - Country:US
Practice Address - Phone:978-462-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA588231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist