MEDICARE: MISS JESSICA MCFADDEN M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1144729047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JESSICA MCFADDEN M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	17 GOOSE NECK LN APT 201
Second Line	:
City	:	FISHERSVILLE
State	:	VA
Zip	:	22939-2427
Country	:	US
Telephone Number	:	814-221-8144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1088 AUGUSTA FARMS RD
Second Line	:
City	:	STUARTS DRAFT
State	:	VA
Zip	:	24477-3200
Country	:	US
Telephone Number	:	540-946-7611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	02/06/2018

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Directions to “ MISS JESSICA MCFADDEN M.A., CCC-SLP” Practice Location

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