Individual
JESSICA ANNELIESE MACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
901 N SANTA FE AVE, FOUNTAIN, CO 80817-1738
(719) 822-0550
Mailing address
4629 SHEMIN CT APT C, COLORADO SPRINGS, CO 80902-1229
(661) 886-1023
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0004416
CO
235Z00000X
Speech-Language Pathologist
13452
NC
235Z00000X
Speech-Language Pathologist
Primary
2202011328
VA
Other
Enumeration date
05/31/2018
Last updated
10/14/2024
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