Provider Demographics
NPI:1851628226
Name:PADULA, JESSICA MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARIE
Last Name:PADULA
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Gender:F
Credentials:MS CCC-SLP
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Mailing Address - Street 1:364 BOSTON TURNPIKE ROAD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3872
Mailing Address - Country:US
Mailing Address - Phone:508-757-6981
Mailing Address - Fax:508-757-0166
Practice Address - Street 1:364 BOSTON TURNPIKE ROAD
Practice Address - Street 2:SUITE 1A
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3872
Practice Address - Country:US
Practice Address - Phone:508-757-6981
Practice Address - Fax:508-757-0166
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
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Provider Licenses
StateLicense IDTaxonomies
MA7073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist