MEDICARE: JESSICA SMITH 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
1	235Z00000X	Speech-Language Pathologist	146.010798	IL

General Provider Information

NPI Number	:	1306128632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SMITH SLP

Provider Business Mailing Address
First Line	:	1860 N LINCOLN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-7301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1860 N LINCOLN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2996
Country	:	US
Telephone Number	:	815-575-1744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	02/15/2024

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Directions to “ JESSICA SMITH SLP” Practice Location

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