Jenna Bivens
Speech-Language Pathologist, in Dupo, IL. Individual provider (NPI-1).
NPI number1831864321
StatusActive
Last updated in NPPESAug 16, 2021
Details
- NPI
- 1831864321
- Entity type
- Individual (NPI-1)
- Name
- Jenna Bivens
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 16, 2021
- Certification date
- Aug 16, 2021
- Last updated
- Aug 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
Practice location
905 Bluffview Elementary LnDupo, IL 62239-1544
Phone 618-286-3311
Mailing address
781 Lake Lucille DrWaterloo, IL 62298-3233
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