Provider Demographics
NPI:1851132591
Name:JENNINGS, ZOE MADELINE (MS, CF-SLP)
Entity type:Individual
Prefix:MISS
First Name:ZOE
Middle Name:MADELINE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26641 PRIVATE ROAD 1000
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:MO
Mailing Address - Zip Code:65772-6285
Mailing Address - Country:US
Mailing Address - Phone:479-231-6610
Mailing Address - Fax:
Practice Address - Street 1:5507 W WALSH LN STE 102
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8951
Practice Address - Country:US
Practice Address - Phone:479-367-2806
Practice Address - Fax:479-367-2648
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR14447939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist