Individual
JESSICA ANN OLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15143 N CHERRY CT, PARKVILLE, MO 64152-1640
(217) 276-5377
Mailing address
15143 N CHERRY CT, PARKVILLE, MO 64152-1640
(217) 276-5377
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009014885
MO
Other
Enumeration date
12/13/2006
Last updated
06/11/2015
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