Provider Demographics
NPI:1588334502
Name:JUPITER, LEENETTE MARIE
Entity type:Individual
Prefix:MRS
First Name:LEENETTE
Middle Name:MARIE
Last Name:JUPITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 BRIARCHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-2755
Mailing Address - Country:US
Mailing Address - Phone:281-891-8465
Mailing Address - Fax:
Practice Address - Street 1:16717 ELLA BLVD # 11
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4213
Practice Address - Country:US
Practice Address - Phone:281-891-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334072355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant