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NPI Code Detail

MEDICARE: MS. JESSICA PAULETTE MOREHEAD SLP

MEDICARE:  MS. JESSICA PAULETTE MOREHEAD  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1104179464
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA PAULETTE MOREHEAD SLP
Provider Business Mailing Address
First Line : 55 BLUE SPRINGS BRANCH RD
Second Line :
City : VANCEBURG
State : KY
Zip : 41179-7894
Country : US
Telephone Number : 304-663-8810
Fax Number :
Provider Business Practice Location Address
First Line : 55 BLUE SPRINGS BRANCH RD
Second Line :
City : VANCEBURG
State : KY
Zip : 41179-7894
Country : US
Telephone Number : 304-663-8810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2012
Last Update Date : 06/25/2015

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Directions to “ MS. JESSICA PAULETTE MOREHEAD SLP” Practice Location

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