Provider Demographics
NPI:1104370386
Name:SOCCIO, JESSICA (AUD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:SOCCIO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 GIFFORD ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-5106
Mailing Address - Country:US
Mailing Address - Phone:508-548-8123
Mailing Address - Fax:
Practice Address - Street 1:332 GIFFORD ST
Practice Address - Street 2:UNIT 1
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5106
Practice Address - Country:US
Practice Address - Phone:508-548-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-1108-AU231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist