Provider Demographics
NPI:1417783382
Name:WESTHOFF, JEAN (SPEECH-LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:WESTHOFF
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TIMBER MILL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-3614
Mailing Address - Country:US
Mailing Address - Phone:203-496-1088
Mailing Address - Fax:
Practice Address - Street 1:75 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6098
Practice Address - Country:US
Practice Address - Phone:203-496-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist