Individual
JENNIFER B. NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-6415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
235Z00000X
Speech-Language Pathologist
Primary
2006011487
MO
235Z00000X
Speech-Language Pathologist
SA2618
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466291507
—
MO
05
—
882188700
—
FL
Enumeration date
09/26/2006
Last updated
07/21/2022
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