Provider Demographics
NPI:1598937567
Name:FISHER, JESSICA E (SLP/ASSIST)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:E
Last Name:FISHER
Suffix:
Gender:F
Credentials:SLP/ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 HEMPSTEAD 166 S
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8920
Mailing Address - Country:US
Mailing Address - Phone:870-703-0643
Mailing Address - Fax:
Practice Address - Street 1:11630 HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:STEPHENS
Practice Address - State:AR
Practice Address - Zip Code:71764-8020
Practice Address - Country:US
Practice Address - Phone:870-510-2841
Practice Address - Fax:870-510-2000
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARDDS2022355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR166906721Medicaid
ARDDS202OtherSLP/A REGISTRATION NUMBER