Provider Demographics
NPI:1538784491
Name:PARRY, JESSICA KATHERINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATHERINE
Last Name:PARRY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 N PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-8715
Mailing Address - Country:US
Mailing Address - Phone:570-406-0425
Mailing Address - Fax:
Practice Address - Street 1:3 W OLIVE STREET
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2572
Practice Address - Country:US
Practice Address - Phone:570-963-3823
Practice Address - Fax:570-207-5988
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL016309235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist