Provider Demographics
NPI:1063396422
Name:FERGUSON, JENNIFER (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1598 JOHNSON YOUNG RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTEAD
Mailing Address - State:KY
Mailing Address - Zip Code:42265-9635
Mailing Address - Country:US
Mailing Address - Phone:270-221-5106
Mailing Address - Fax:
Practice Address - Street 1:1100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2079
Practice Address - Country:US
Practice Address - Phone:270-707-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY142543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist