Provider Demographics
NPI:1972262533
Name:YINGER, JENNFIER LAUREN COLWELL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNFIER
Middle Name:LAUREN COLWELL
Last Name:YINGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LAUREN
Other - Last Name:COLWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4905 SUMMIT ARBOR DR APT 305
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4057
Mailing Address - Country:US
Mailing Address - Phone:803-319-0592
Mailing Address - Fax:
Practice Address - Street 1:4905 SUMMIT ARBOR DR APT 305
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4057
Practice Address - Country:US
Practice Address - Phone:954-247-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31966235Z00000X
NC14399235Z00000X
TN6842235Z00000X
HISP-2010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist