Provider Demographics
NPI:1811258668
Name:DIMMICK, JESSICA EILEEN RHODES (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:EILEEN RHODES
Last Name:DIMMICK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:EILEEN
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-2929
Mailing Address - Country:US
Mailing Address - Phone:309-221-5476
Mailing Address - Fax:
Practice Address - Street 1:1810 SW WHITE BIRCH CIR STE 104
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7226
Practice Address - Country:US
Practice Address - Phone:515-964-1134
Practice Address - Fax:844-348-9007
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9976231H00000X
IA079968231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist