Provider Demographics
NPI:1215505086
Name:HARVEY, JESSICA R (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:R
Last Name:HARVEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 MIDDLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4472
Mailing Address - Country:US
Mailing Address - Phone:812-372-1886
Mailing Address - Fax:812-372-8156
Practice Address - Street 1:3105 MIDDLE RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4472
Practice Address - Country:US
Practice Address - Phone:812-372-1886
Practice Address - Fax:812-372-8156
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002752A231HA2400X, 231HA2500X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN23002752AOtherSTATE LICENSE