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General NPI Number Information
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NPI Number | 1366884975
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Entity Type | Individual
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Provider Name | JESSICA L. ROWAN CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 9201 STATE HIGHWAY 17 STE F
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City | ELGIN
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State | OK
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Zip | 73538-4517
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Country | US
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Telephone | 580-454-9200
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Fax | 580-454-9205
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Provider Business Mailing Address
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Address Line | 9201 STATE HIGHWAY 17 STE F
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City | ELGIN
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State | OK
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Zip | 73538-4517
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Country | US
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Telephone | 580-678-3320
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 108944
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4344
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License Number State | OK
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