| Doctor Name: | MS. JESSICA CANDICE WOLVERTON |
| NPI Number: | 1821311432 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MCD, CCC-SLP |
| License Number: | 924768805 |
| Business Practice Address: | 120 Nix Ridge Rd Ash Flat, AR - 725139017 |
| Business Phone Number: | 8702191086 |
| Business Fax Number: | |
| Mailing Address: | Po Box 573, ASH FLAT |
| State: | AR |
| Postal Code: | 72513 |
| Phone Number: | 8702191086 |
| Fax Number: | |
| NPI Enumeration Date: | 03/10/2010 |
| NPI Last Update Date: | 03/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 924768805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| 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 |