Provider Demographics
NPI:1902286024
Name:GARRISON, JENNIFER H (MA,, SLP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:H
Last Name:GARRISON
Suffix:
Gender:F
Credentials:MA,, SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3546 CALLE SUENOS SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6716
Mailing Address - Country:US
Mailing Address - Phone:913-530-1737
Mailing Address - Fax:505-396-4598
Practice Address - Street 1:3546 CALLE SUENOS SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6716
Practice Address - Country:US
Practice Address - Phone:913-530-1737
Practice Address - Fax:505-396-4598
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-3022235Z00000X
NMSLP7520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist