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NPI Code Detail

MEDICARE: MRS. JESSICA WRIGHT M.S., CCC-SLP

MEDICARE: MRS. JESSICA WRIGHT 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
1235Z00000XSpeech-Language Pathologist103565TX

Other Identifiers

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

General Provider Information

NPI Number : 1790932416
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA WRIGHT M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1710 MOORES LN
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-1858
Country : US
Telephone Number : 903-794-2705
Fax Number : 903-793-1203
Provider Business Practice Location Address
First Line : 1710 MOORES LN
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-1858
Country : US
Telephone Number : 903-794-2705
Fax Number : 903-793-1203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2008
Last Update Date : 07/01/2020

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