Provider Demographics
NPI:1497143176
Name:RICE, TESSA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 354
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-0354
Mailing Address - Country:US
Mailing Address - Phone:740-250-3703
Mailing Address - Fax:
Practice Address - Street 1:522 GLENWOOD AVE RM 165
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:OH
Practice Address - Zip Code:45662-5505
Practice Address - Country:US
Practice Address - Phone:740-354-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.10974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist