| NPI | 1235279266 |
|---|---|
| Former Name | JENNIFER JEAN FARGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 268) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA 1068) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2025-09-11 |