Doctor Name: | JESSICA WIRTLEY |
NPI Number: | 1114310976 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2015101 |
Business Practice Address: | 9680 Cincinnati Columbus Rd West Chester, OH - 452411071 |
Business Phone Number: | 5137778599 |
Business Fax Number: | |
Mailing Address: | 6116 Hursh Rd, MIDDLETOWN |
State: | OH |
Postal Code: | 450428938 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/17/2015 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2015101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |