Provider Demographics
NPI:1821250937
Name:JAEGER, JESSICA L (MS)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:JAEGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:LARUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7208 S COLONY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3931
Mailing Address - Country:US
Mailing Address - Phone:615-440-0300
Mailing Address - Fax:
Practice Address - Street 1:215 DUNBAR CAVE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8849
Practice Address - Country:US
Practice Address - Phone:931-368-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist