Provider Demographics
NPI:1891950291
Name:HOWARD, JESSICA MICHELLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MICHELLE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E 1000 S
Mailing Address - Street 2:
Mailing Address - City:KOUTS
Mailing Address - State:IN
Mailing Address - Zip Code:46347-9730
Mailing Address - Country:US
Mailing Address - Phone:219-309-5799
Mailing Address - Fax:
Practice Address - Street 1:401 15TH ST SE
Practice Address - Street 2:
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-9043
Practice Address - Country:US
Practice Address - Phone:219-662-8929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011274A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist