MEDICARE: JESSICA CLAYPOOL M.S. 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	3502	NM

General Provider Information

NPI Number	:	1265468284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CLAYPOOL M.S. CCC SLP

Provider Business Mailing Address
First Line	:	PO BOX 26322
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00824-2322
Country	:	US
Telephone Number	:	340-719-4334
Fax Number	:

Provider Business Practice Location Address
First Line	:	2133 HOSPITAL STREET
Second Line	:	DEPARTMENT OF SPECIAL EDUCATION
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00824
Country	:	US
Telephone Number	:	340-773-7997
Fax Number	:

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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