Basic Information
| Provider Information | |||||||||
| NPI: | 1023487261 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMSON | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 510 E NORTH BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432144114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142635151 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2365 CLINTON AVE S | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146182663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857585700 | ||||||||
| FaxNumber: | 5857581297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2015 | ||||||||
| LastUpdateDate: | 02/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 002622 | NY | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | A02291 | OH | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.