Most Relevant Information
Provider Data
| NPI Number: | 1003338294 |
| Provider Name: | JENINE ENTWISTLE VIOLE MSP CCC-SLP LSLS AVT |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 12928 |
Most Important Dates
| Enumeration Date: | 07/10/2017 |
| Last Updated: | 02/18/2022 |
Provider Practice Location
3201 W MARKET ST
GREENSBORO
NC
274031455
Practice Location Phone/Fax
| Phone: | 3365418167 |
| Fax: | 3366630266 |
Provider Mailing Location
33 TRUMAN ST
WINSTON SALEM
NC
271064948
Provider Mailing Phone/Fax
| Phone: | 2035229943 |
| Fax: |