Individual
MS. JENNIFER LYNN RESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D., CCC-A
Contact information
Practice address
100 STATE AVE, FARIBAULT, MN 55021
(507) 334-5915
(507) 332-6683
Mailing address
100 STATE AVE, FARIBAULT, MN 55021
(507) 334-5915
(507) 332-6683
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7922
MN
237600000X
Audiologist-Hearing Aid Fitter
7922
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640000378
—
MN
Enumeration date
12/06/2006
Last updated
03/11/2021
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