Provider Demographics
NPI:1932933454
Name:MADDEN, JESSICA F
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:F
Last Name:MADDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:F
Other - Last Name:SEAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:239 BOG RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-3425
Mailing Address - Country:US
Mailing Address - Phone:301-452-4754
Mailing Address - Fax:
Practice Address - Street 1:9 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-3479
Practice Address - Country:US
Practice Address - Phone:301-452-4754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP4060235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist