Provider Demographics
NPI:1932847415
Name:MULLIGAN, JENNIFER ANNE (MA SPEECH PATHOLOGY)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:MA SPEECH PATHOLOGY
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Mailing Address - Street 1:13671 S VESTRY RD
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7522
Mailing Address - Country:US
Mailing Address - Phone:385-414-7537
Mailing Address - Fax:
Practice Address - Street 1:9361 S 300 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2902
Practice Address - Country:US
Practice Address - Phone:801-826-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist