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General NPI Number Information
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NPI Number | 1821879347
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Entity Type | Individual
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Provider Name | JESSICA IRENE MEADOWS M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 13331 REECK RD UNIT 201
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City | SOUTHGATE
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State | MI
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Zip | 48195
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Country | US
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Telephone | 734-675-3908
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Fax | 734-675-3925
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Provider Business Mailing Address
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Address Line | 3407 15TH ST
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City | WYANDOTTE
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State | MI
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Zip | 48192-6123
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Country | US
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Telephone | 347-652-2888
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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 | 7101008650
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License Number State | MI
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