Provider Demographics
NPI:1366068199
Name:SALISBURY, JENNIFER (BC-HIS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W PINNACLE PEAK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1224
Mailing Address - Country:US
Mailing Address - Phone:623-582-6699
Mailing Address - Fax:
Practice Address - Street 1:2222 W PINNACLE PEAK RD STE 170
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1224
Practice Address - Country:US
Practice Address - Phone:623-582-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD1673237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist