Doctor Name: | JESSICA WEICKS |
NPI Number: | 1598925810 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 5940 |
Business Practice Address: | 24265 Cane Byu Lacombe, LA - 704456125 |
Business Phone Number: | 9858694183 |
Business Fax Number: | |
Mailing Address: | 132 Butternut Ln, MANDEVILLE |
State: | LA |
Postal Code: | 704481096 |
Phone Number: | 9856740357 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2008 |
NPI Last Update Date: | 06/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5940 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
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 |