| Mrs Jennifer Kirstin Daniels, MA, CCC-SLP | |
|
3680 Dolson Ct, Carroll, OH 43112-9721 | |
| (740) 654-0641 | |
| Not Available |
| Full Name | Mrs Jennifer Kirstin Daniels |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 3680 Dolson Ct, Carroll, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881086700 | NPI | - | NPPES |
| SP. 11414 | Other | OH | OHIO BOARD OF SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY |
| 14054472 | Other | OH | ASHA CERTIFICATE OF CLINICAL COMPETENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SP. 11414 (Ohio) | Primary |
| Provider Name | Enliven Rehabilitation Services Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1386202554 PECOS PAC ID: 1850626375 Enrollment ID: O20190705000167 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jennifer Kirstin Daniels, MA, CCC-SLP 1865 Hard Rd, Columbus, OH 43235-5928 Ph: (419) 438-0820 | Mrs Jennifer Kirstin Daniels, MA, CCC-SLP 3680 Dolson Ct, Carroll, OH 43112-9721 Ph: (740) 654-0641 |
Carla Youngdahl Berg, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3680 Dolson Ct, Carroll, OH 43112 Phone: 740-654-0641 Fax: 740-654-3896 | |
Mrs. Regina Kiefer, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 55 High St, Carroll, OH 43112 Phone: 740-639-4218 | |
Jessica Dodds, M.A. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3680 Dolson Ct, Carroll, OH 43112 Phone: 740-654-0641 |