Individual
MRS. JESSICA SANDERS ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, CCC SLP
Contact information
Practice address
2412 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 224-4081
Mailing address
2412 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 224-4081
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100344990
—
KY
Enumeration date
11/27/2006
Last updated
07/28/2020
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