Provider Demographics
NPI:1437696788
Name:SCHOENEN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SCHOENEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5491 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:LAURYS STATION
Mailing Address - State:PA
Mailing Address - Zip Code:18059-1337
Mailing Address - Country:US
Mailing Address - Phone:610-392-7113
Mailing Address - Fax:
Practice Address - Street 1:5491 ASHLEY DR
Practice Address - Street 2:
Practice Address - City:LAURYS STATION
Practice Address - State:PA
Practice Address - Zip Code:18059-1337
Practice Address - Country:US
Practice Address - Phone:610-392-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist