Provider Demographics
NPI:1174513881
Name:GAPINSKI, JENNY REBECCA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:REBECCA
Last Name:GAPINSKI
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 1:26922 N 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-7304
Mailing Address - Country:US
Mailing Address - Phone:847-276-1881
Mailing Address - Fax:
Practice Address - Street 1:20329 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6853
Practice Address - Country:US
Practice Address - Phone:480-613-9961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-003850235Z00000X
AZSLP1492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist