National Provider Identifier

Jennifer Kay Divine, SLP

Jennifer Kay Divine, SLP is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Orchard Park, NY and a listed phone number of (716) 662-4800.

NPI 1821731183Orchard Park, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1821731183
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
April 15, 2022
Last Updated
April 15, 2022

Practice Location

  • 6167 W Quaker St
  • Orchard Park, NY 14127-2640

Phone: (716) 662-4800

Mailing Address

  • 5563 Meadow Dr
  • Hamburg, NY 14075-6935

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1821731183
Entity Type
Individual
Last Name
Divine
First Name
Jennifer
Middle Name
Kay
Credential
SLP
Mailing Street Address
5563 Meadow Dr
Mailing City
Hamburg
Mailing State
NY
Mailing ZIP Code
14075-6935
Mailing Country
US
Mailing Phone
(716) 803-0625
Mailing Fax
(716) 662-5700
Practice Street Address
6167 W Quaker St
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-2640
Practice Country
US
Practice Phone
(716) 662-4800
Practice Fax
(716) 662-4700
Enumeration Date
April 15, 2022
Last Updated
April 15, 2022
Sex
Female
Sole Proprietor
No
Certification Date
April 15, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X), Speech-Language Pathologist (235Z00000X)