Provider Demographics
NPI:1205123049
Name:PREWITT, JESSICA MARIE-FALGNER (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE-FALGNER
Last Name:PREWITT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 LEATHER LEAF LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7791
Mailing Address - Country:US
Mailing Address - Phone:937-725-1824
Mailing Address - Fax:
Practice Address - Street 1:11135 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2338
Practice Address - Country:US
Practice Address - Phone:513-429-4327
Practice Address - Fax:513-429-4346
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01773231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist