MEDICARE: JESSICA L FOWEE MA. 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	SP.11221	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265826739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L FOWEE MA. CCC-SLP

Provider Business Mailing Address
First Line	:	9680 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45241-1071
Country	:	US
Telephone Number	:	513-777-8599
Fax Number	:	513-777-8198

Provider Business Practice Location Address
First Line	:	9680 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45241-1071
Country	:	US
Telephone Number	:	513-777-8599
Fax Number	:

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

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	10/21/2021

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