Healthcare Provider Details

I. General information

NPI: 1891606208
Provider Name (Legal Business Name): JESSICA ARTHUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 COMMERCE CENTER BLVD
FAIRBORN OH
45324-6351
US

IV. Provider business mailing address

1143 COTTAGE COURT DR
FAIRBORN OH
45324-5714
US

V. Phone/Fax

Practice location:
  • Phone: 937-879-3611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: