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General NPI Number Information
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NPI Number | 1588836035
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Entity Type | Individual
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Provider Name | ANDREA MICHELLE JASPER M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 230 NW 76TH DR
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City | GAINESVILLE
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State | FL
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Zip | 32607-6672
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Country | US
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Telephone | 352-642-6182
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Fax |
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Provider Business Mailing Address
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Address Line | 2659 SW 118TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32608-0010
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Country | US
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Telephone | 352-642-6182
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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 | SA 9159
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License Number State | FL
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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 | SA9159
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License Number State | FL
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