Provider Demographics
NPI:1457906976
Name:SCRIBNER, JESSAMINE RAE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSAMINE
Middle Name:RAE
Last Name:SCRIBNER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7264 EAGLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9250
Mailing Address - Country:US
Mailing Address - Phone:260-452-7742
Mailing Address - Fax:
Practice Address - Street 1:7264 EAGLESTONE CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9250
Practice Address - Country:US
Practice Address - Phone:260-452-7742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.13539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist