Provider Demographics
NPI:1194174490
Name:GAUGHAN, JESSICA GRACE (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:GRACE
Last Name:GAUGHAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:GRACE
Other - Last Name:HARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 SW LANE ST
Mailing Address - Street 2:STE 200
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2549
Mailing Address - Country:US
Mailing Address - Phone:785-233-0500
Mailing Address - Fax:
Practice Address - Street 1:920 SW LANE ST
Practice Address - Street 2:STE 200
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2549
Practice Address - Country:US
Practice Address - Phone:785-233-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist