Provider Demographics
NPI:1699143727
Name:BARNETT, JESSICA KATHERINE ELAINE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KATHERINE ELAINE
Last Name:BARNETT
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:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:TUPPERS PLAINS
Mailing Address - State:OH
Mailing Address - Zip Code:45783-0205
Mailing Address - Country:US
Mailing Address - Phone:740-667-6211
Mailing Address - Fax:
Practice Address - Street 1:36759 ROCKSPRINGS RD
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:OH
Practice Address - Zip Code:45769-9730
Practice Address - Country:US
Practice Address - Phone:740-992-2678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-05
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 8844235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist