Provider Demographics
NPI:1922443084
Name:IRVING, JESSICA L (MS-CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:L
Last Name:IRVING
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8339 DAVINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-7604
Mailing Address - Country:US
Mailing Address - Phone:614-389-7992
Mailing Address - Fax:
Practice Address - Street 1:8339 DAVINGTON DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7604
Practice Address - Country:US
Practice Address - Phone:614-389-7992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist