Provider Demographics
NPI:1801809199
Name:STRATTON, JESSICA LYNN
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:STRATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:OFFILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7032 OCCIDENTAL RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6305
Mailing Address - Country:US
Mailing Address - Phone:972-768-8073
Mailing Address - Fax:
Practice Address - Street 1:1201 E 15TH ST
Practice Address - Street 2:#304
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6238
Practice Address - Country:US
Practice Address - Phone:972-424-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102394T235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6109OtherBLUE CROSS BLUE SHIELD
TX7754812OtherAETNA