Provider Demographics
NPI:1770328742
Name:VEAL, JESSICA RUTH
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RUTH
Last Name:VEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9455 HARROWAY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8598
Mailing Address - Country:US
Mailing Address - Phone:843-697-5377
Mailing Address - Fax:843-285-8266
Practice Address - Street 1:9455 HARROWAY RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8598
Practice Address - Country:US
Practice Address - Phone:843-697-5377
Practice Address - Fax:843-285-8266
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency