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NPI Code Detail

MEDICARE: MRS. JESSICA GRACE HOURDAS MS, CCC/SLP

MEDICARE: MRS. JESSICA GRACE HOURDAS MS, 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 PathologistSA9050FL

General Provider Information

NPI Number : 1487992152
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA GRACE HOURDAS MS, CCC/SLP
Provider Business Mailing Address
First Line : 7657 CITA LN
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34653-6221
Country : US
Telephone Number : 727-376-1111
Fax Number : 727-376-1113
Provider Business Practice Location Address
First Line : 7657 CITA LN
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34653-6221
Country : US
Telephone Number : 727-376-1111
Fax Number : 727-376-1113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2013
Last Update Date : 01/30/2013

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