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1851725691 NPI number — JESSICA LAUREN TALLENT M.S. CF-SLP

NPI Number: 1851725691
Health Care Provider/Practitioner: JESSICA LAUREN TALLENT M.S. CF-SLP

Information about “1851725691” NPI (JESSICA LAUREN TALLENT M.S. CF-SLP) exists in 1851725691 in HTML format HTML  |  1851725691 in plain Text format TXT  |  1851725691 in PDF (Portable Document Format) PDF  |  1851725691 in an XML format XML  formats.

NPI Number : 1851725691 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851725691",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TALLENT",
    "FirstName": "JESSICA",
    "MiddleName": "LAUREN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S. CF-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STATON",
    "OtherFirstName": "JESSICA",
    "OtherMiddleName": "LAUREN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "156 BLUFF RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBANY",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "42602-8974",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "606-306-7036",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "216 POPLAR AVE",
    "SecondLinePracticeLocationAddress": "SUITE 101",
    "PracticeLocationAddressCityName": "SOMERSET",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "42503-1764",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-677-1166",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/28/2013",
    "LastUpdateDate": "08/28/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "13-044",
        "LicenseNumberStateCode": "KY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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