Individual
MRS. JENNIFER L ROSENTHAL-DIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4602 CUMBERLAND RD, FAYETTEVILLE, NC 28306-2412
(910) 423-5622
(910) 423-5538
Mailing address
4602 CUMBERLAND RD, FAYETTEVILLE, NC 28306-2412
(910) 423-5622
(910) 378-1755
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3200
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156E
BLUE CROSS/BLUE SHIELD
NC
05
—
7464046
—
NC
Enumeration date
11/09/2005
Last updated
03/15/2021
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