National Provider Identifier
Jennifer M Jackson, SLP
Jennifer M Jackson, SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in East Amherst, NY and a listed phone number of (716) 626-8000.
Profile Overview
- NPI
- 1457422156
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- November 13, 2006
- Last Updated
- January 10, 2012
Practice Location
- 105 Casey RD
- East Amherst, NY 14051-2224
Phone: (716) 626-8000
Mailing Address
- 82 Irving Ter
- Tonawanda, NY 14223-2740
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1457422156
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Jennifer
- Middle Name
- M
- Name Prefix
- MS.
- Credential
- SLP
- Provider Other Last Name
- Bongiovanni
- Provider Other First Name
- Jennifer
- Provider Other Middle Name
- M
- Provider Other Name Prefix Text
- Mrs.
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 82 Irving Ter
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14223-2740
- Mailing Country
- US
- Mailing Phone
- (716) 864-1921
- Practice Street Address
- 105 Casey RD
- Practice City
- East Amherst
- Practice State
- NY
- Practice ZIP Code
- 14051-2224
- Practice Country
- US
- Practice Phone
- (716) 626-8000
- Practice Fax
- (716) 626-8089
- Enumeration Date
- November 13, 2006
- Last Updated
- January 10, 2012
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)