Provider Demographics
NPI:1841325495
Name:CARRINGTON, JESSICA (MA,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WESTVALE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-9100
Mailing Address - Country:US
Mailing Address - Phone:573-579-3719
Mailing Address - Fax:
Practice Address - Street 1:135 WESTVALE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-9100
Practice Address - Country:US
Practice Address - Phone:573-579-3719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003018476235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist