Most Relevant Information
Provider Data
| NPI Number: | 1003409269 |
| Provider Name: | JENNIFER DUBOSE |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 115782 |
Most Important Dates
| Enumeration Date: | 02/18/2021 |
| Last Updated: | 06/03/2022 |
Provider Practice Location
300 ROE ST
AZLE
TX
760203106
Practice Location Phone/Fax
| Phone: | 8174443235 |
| Fax: |
Provider Mailing Location
3001 CROCKETT ST APT 1676
FORT WORTH
TX
761073292
Provider Mailing Phone/Fax
| Phone: | 9366355699 |
| Fax: |