Provider Demographics
NPI:1649549114
Name:POLLARD, JESSICA R (CCC-SLP, TSHH)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:R
Last Name:POLLARD
Suffix:
Gender:F
Credentials:CCC-SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PETTINE ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3019
Mailing Address - Country:US
Mailing Address - Phone:917-940-9241
Mailing Address - Fax:
Practice Address - Street 1:5 PETTINE ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818
Practice Address - Country:US
Practice Address - Phone:917-940-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016105-1235Z00000X
RISP00961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist