Provider Demographics
NPI:1215643499
Name:HENSLEY, JENNIFER (MS SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36714 CANYON RD
Mailing Address - Street 2:
Mailing Address - City:WALLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77485-8715
Mailing Address - Country:US
Mailing Address - Phone:281-814-1608
Mailing Address - Fax:
Practice Address - Street 1:1440 13TH ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-5910
Practice Address - Country:US
Practice Address - Phone:979-826-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119089235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist