Provider Demographics
NPI:1770526428
Name:NORTON, JESSICA J (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:J
Last Name:NORTON
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:UVA SPEECH-LANGUAGE-HEARING CENTER
Mailing Address - Street 2:2205 FONTAINE AVE., SUITE 202
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-924-6318
Mailing Address - Fax:434-924-4621
Practice Address - Street 1:UVA SPEECH-LANGUAGE-HEARING CENTER
Practice Address - Street 2:2205 FONTAINE AVE., SUITE 202
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-924-6318
Practice Address - Fax:434-924-4621
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7960722OtherAETNA PROVIDER ID NUMBER
VA1115484OtherAETNA HMO PROVIDER NUMBER
VA11516675OtherCAQH PROVIDER ID