MEDICARE: JESSICA A THOMPSON 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	SLP009555	GA

General Provider Information

NPI Number	:	1871012492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA A THOMPSON SLP

Provider Business Mailing Address
First Line	:	1835 SAVOY DR STE 101B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-1073
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:	866-857-8655

Provider Business Practice Location Address
First Line	:	1835 SAVOY DR STE 101B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-1073
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:	866-857-8655

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

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	07/21/2022

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Directions to “ JESSICA A THOMPSON SLP” Practice Location

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