Provider Demographics
NPI:1194928572
Name:HOVSEPIAN, JENNIFER CERRON (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CERRON
Last Name:HOVSEPIAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 PRIORY CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5568
Mailing Address - Country:US
Mailing Address - Phone:407-924-2917
Mailing Address - Fax:
Practice Address - Street 1:1110 PRIORY CIR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5568
Practice Address - Country:US
Practice Address - Phone:407-924-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2009-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9910235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892198900Medicaid