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NPI Code Detail

MEDICARE: JESSICA VICK

MEDICARE: JESSICA VICK
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 PathologistSLP012547GA

General Provider Information

NPI Number : 1427789171
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA VICK
Provider Business Mailing Address
First Line : 1168 PARKSIDE TRL
Second Line :
City : EVANS
State : GA
Zip : 30809-5234
Country : US
Telephone Number : 706-339-7465
Fax Number :
Provider Business Practice Location Address
First Line : 3104 SKINNER MILL RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-1968
Country : US
Telephone Number : 706-339-7465
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2022
Last Update Date : 05/26/2023

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Directions to “ JESSICA VICK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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