Provider Demographics
NPI:1386049617
Name:DAILY, JENNIFER (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DAILY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MCKENNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2032 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1119
Mailing Address - Country:US
Mailing Address - Phone:215-742-7767
Mailing Address - Fax:215-742-6811
Practice Address - Street 1:2032 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1119
Practice Address - Country:US
Practice Address - Phone:215-742-7767
Practice Address - Fax:215-742-6811
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00098000237700000X
PAF3074237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist