Doctor Name: | JESSICA TERAVEST |
NPI Number: | 1104218023 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 05831 |
Business Practice Address: | 6915 Laurel Bowie Rd Ste 205 Bowie, MD - 207151703 |
Business Phone Number: | 2402454370 |
Business Fax Number: | 2402454472 |
Mailing Address: | 6915 Laurel Bowie Rd, Ste 205 BOWIE |
State: | MD |
Postal Code: | 207151703 |
Phone Number: | 2402454370 |
Fax Number: | 2402454472 |
NPI Enumeration Date: | 03/02/2015 |
NPI Last Update Date: | 03/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 05831 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |