Provider Demographics
NPI:1316335276
Name:MUGNIER, JENNIFER (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MUGNIER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BLUNDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2672 HIGHWAY 183
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-5706
Mailing Address - Country:US
Mailing Address - Phone:620-635-5203
Mailing Address - Fax:
Practice Address - Street 1:2672 HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-5706
Practice Address - Country:US
Practice Address - Phone:620-635-5203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist