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NPI Code Detail

MEDICARE: JESSICA HUDSON M.A. CCC-SLP

MEDICARE:   JESSICA  HUDSON  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 PathologistTSLP8510AZ

General Provider Information

NPI Number : 1952734717
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HUDSON M.A. CCC-SLP
Provider Business Mailing Address
First Line : 3635 E INVERNESS AVE STE 104
Second Line :
City : MESA
State : AZ
Zip : 85206-3848
Country : US
Telephone Number : 480-719-6535
Fax Number :
Provider Business Practice Location Address
First Line : 3635 E INVERNESS AVE STE 104
Second Line :
City : MESA
State : AZ
Zip : 85206-3848
Country : US
Telephone Number : 480-719-6535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2013
Last Update Date : 08/31/2020

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Directions to “ JESSICA HUDSON M.A. CCC-SLP” Practice Location

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