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NPI Code Detail

MEDICARE: JENNIFER B LUCIA CCC-SLP

MEDICARE: JENNIFER B LUCIA 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 Pathologist2203000406VA

General Provider Information

NPI Number : 1558837062
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER B LUCIA CCC-SLP
Provider Business Mailing Address
First Line : 310 S BRIDGE ST
Second Line :
City : BEDFORD
State : VA
Zip : 24523-2706
Country : US
Telephone Number : 540-586-1045
Fax Number :
Provider Business Practice Location Address
First Line : 310 S BRIDGE ST
Second Line :
City : BEDFORD
State : VA
Zip : 24523-2706
Country : US
Telephone Number : 540-586-1045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2018
Last Update Date : 08/06/2020

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Directions to “ JENNIFER B LUCIA CCC-SLP” Practice Location

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