Individual
JESSICA FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
294 N WINNEBAGO DR, LAKE WINNEBAGO, MO 64034-9319
(913) 709-1152
Mailing address
294 N WINNEBAGO DR, LAKE WINNEBAGO, MO 64034-9319
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
16792
OR
235Z00000X
Speech-Language Pathologist
Primary
2012012466
MO
235Z00000X
Speech-Language Pathologist
3209
KS
Other
Enumeration date
12/26/2014
Last updated
01/10/2023
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