Provider Demographics
NPI:1568770337
Name:HEWITT, JESSICA INEZ (AUD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:INEZ
Last Name:HEWITT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:INEZ
Other - Last Name:CAMERLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6001 STONEWOOD DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7380
Mailing Address - Country:US
Mailing Address - Phone:724-940-5755
Mailing Address - Fax:
Practice Address - Street 1:6001 STONEWOOD DRIVE
Practice Address - Street 2:STE 301
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:724-940-5755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006183231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist