Individual
MRS. JENNA BETH WATNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/CCC/SLP
Contact information
Practice address
176 FRANKLIN ST, LYNN, MA 01904-3230
(781) 593-2727
Mailing address
176 FRANKLIN ST, LYNN, MA 01904-3230
(781) 593-2727
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8346
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19221174226
—
MA
05
—
1922174226
—
MA
Enumeration date
11/23/2020
Last updated
11/23/2020
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