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General NPI Number Information
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NPI Number | 1306574330
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Entity Type | Individual
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Provider Name | JEAN ANNE PICKERING MS, CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 202 RED RIVER RD N
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City | REDWATER
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State | TX
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Zip | 75573
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Country | US
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Telephone | 903-671-3481
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 N FM 2148
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City | TEXARKANA
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State | TX
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Zip | 75501-0363
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Country | US
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Telephone | 903-293-3254
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 15324
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License Number State | TX
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