| Doctor Name: | JESSICA CAMP |
| NPI Number: | 1083964597 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 12-0123 |
| Business Practice Address: | 16 Summerwood Dr Magnolia, AR - 717538442 |
| Business Phone Number: | 8709049408 |
| Business Fax Number: | |
| Mailing Address: | 16 Summerwood Dr, MAGNOLIA |
| State: | AR |
| Postal Code: | 717538442 |
| Phone Number: | 8709049408 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2012 |
| NPI Last Update Date: | 09/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355A2700X |
| License Number: | 12-0123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Audiology Assistant |
| Taxonomy Definition: | |