Provider Demographics
NPI:1750895827
Name:JESSET, KATHLEEN O'HARA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:O'HARA
Last Name:JESSET
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 1:17 CANNON DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-2019
Mailing Address - Country:US
Mailing Address - Phone:802-779-3039
Mailing Address - Fax:
Practice Address - Street 1:411 BURRITT RD
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-9202
Practice Address - Country:US
Practice Address - Phone:802-779-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1906235Z00000X
VT144.0132345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist