Ennis, Jennifer

Ennis, Jennifer is an individual health care provider with primary practice located at 140 Wofford Rd , Conway SC 29526-8815. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Ennis, Jennifer can be contacted via phone (843) 455-7505.

Contact Information

Primary practice address
140 Wofford Rd Conway SC 29526-8815
Phone: (843) 455-7505
Fax: (866) 668-9946
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 3066 South Carolina

Profile Details

NPI number 1639114374
LBN Legal business name Ennis, Jennifer
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639114374 NPPES
South Carolina MEDICAID SA0359

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