Doctor Name: | JESSICA CHASE |
NPI Number: | 1104084128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 12892 |
Business Practice Address: | 1485 International Pkwy 2051 Heathrow, FL - 327465303 |
Business Phone Number: | 8007986035 |
Business Fax Number: | |
Mailing Address: | 1485 International Pkwy, 2051 HEATHROW |
State: | FL |
Postal Code: | 327465303 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/27/2008 |
NPI Last Update Date: | 05/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12892 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |