Provider Demographics
NPI:1750941100
Name:KESSLER, JENNA (MSP, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LUDWELL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-2244
Mailing Address - Country:US
Mailing Address - Phone:803-727-5252
Mailing Address - Fax:
Practice Address - Street 1:5175 SUNSET BLVD STE M
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7319
Practice Address - Country:US
Practice Address - Phone:319-580-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty