Provider Demographics
NPI:1619365491
Name:HONDORF, JESSICA (SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HONDORF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:645 BALTIMORE ANNAPOLIS BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3931
Mailing Address - Country:US
Mailing Address - Phone:410-544-2500
Mailing Address - Fax:410-384-9725
Practice Address - Street 1:645 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:STE 111
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3931
Practice Address - Country:US
Practice Address - Phone:410-544-2500
Practice Address - Fax:410-384-9725
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07415235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist