Provider Demographics
NPI:1942745443
Name:SCHMIDT, JESSICA NICOLE (MED, MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MED, MS, CCC-SLP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:N
Other - Last Name:STEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, MS, CCC-SLP
Mailing Address - Street 1:4474 OAKDALE CRESCENT CT APT 724
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6769
Mailing Address - Country:US
Mailing Address - Phone:703-403-5409
Mailing Address - Fax:
Practice Address - Street 1:7617 LITTLE RIVER TPKE STE 310
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-941-7757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA194274544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist