Provider Demographics
NPI:1427470384
Name:BRUTON, JENNIFER LAUREN (MA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LAUREN
Last Name:BRUTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8527
Mailing Address - Country:US
Mailing Address - Phone:513-600-1796
Mailing Address - Fax:
Practice Address - Street 1:1139 DEERHAVEN CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8180
Practice Address - Country:US
Practice Address - Phone:513-600-1796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND 2014026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist