Provider Demographics
NPI:1528788908
Name:FROISTAD, JENNIFER MACINTYRE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MACINTYRE
Last Name:FROISTAD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:MACINTYRE
Other - Last Name:FROISTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:945 RIDDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6987
Mailing Address - Country:US
Mailing Address - Phone:214-796-4422
Mailing Address - Fax:
Practice Address - Street 1:945 RIDDLEWOOD LN
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6987
Practice Address - Country:US
Practice Address - Phone:214-796-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP7781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist