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Individual
JESSICA R MABRY
Active
Individual
JESSICA R MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP CBIS
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA10662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024865200
—
FL
01
—
7N67F
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/01/2018
Last updated
08/09/2018
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