Individual
JENNIFER NEWCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S BIRCH AVE, PRESHO, SD 57568-5311
(605) 895-2579
Mailing address
PO BOX 1000, PRESHO, SD 57568-1000
(605) 895-2579
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12139668
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12139668
—
SD
Enumeration date
09/01/2016
Last updated
09/01/2016
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