Individual
JENNIFER THISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
308 FORD BLDG, PENNSYLVANIA STATE UNIVERSITY, UNIVERSITY PARK, PA 16802-3003
(814) 865-0971
Mailing address
PO BOX 821, STATE COLLEGE, PA 16804-0821
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL010422
PA
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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