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NPI Code Detail

MEDICARE: JESSICA DEINES WEGNER M.A.,CCC-SLP

MEDICARE:   JESSICA DEINES WEGNER  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
1235Z00000XSpeech-Language Pathologist1525NE

General Provider Information

NPI Number : 1295107654
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DEINES WEGNER M.A.,CCC-SLP
Provider Business Mailing Address
First Line : 1255 W DOLORES CT
Second Line :
City : LINCOLN
State : NE
Zip : 68523-7220
Country : US
Telephone Number : 402-239-8239
Fax Number :
Provider Business Practice Location Address
First Line : 1255 W DOLORES CT
Second Line :
City : LINCOLN
State : NE
Zip : 68523-7220
Country : US
Telephone Number : 402-239-8239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2015
Last Update Date : 10/26/2015

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Directions to “ JESSICA DEINES WEGNER M.A.,CCC-SLP” Practice Location

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