Individual
JESSICA PAIGE FAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6622 GORDON RD STE L, WILMINGTON, NC 28411-8415
(910) 407-7211
Mailing address
29 SANDRA RD, PEABODY, MA 01960-5142
(978) 995-3425
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
30002039
NC
235Z00000X
Speech-Language Pathologist
SLP96233
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN60246151
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/16/2020
Last updated
03/17/2025
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