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Individual

JESSICA WITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
230 TOUSLEY AVE S, NEW YORK MILLS, MN 56567-4401
(612) 913-7570
Mailing address
230 TOUSLEY AVE S, NEW YORK MILLS, MN 56567-4401
(612) 913-7570

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
015650
OR
235Z00000X
Speech-Language Pathologist
Primary
7867
MN

Other

Enumeration date
08/18/2016
Last updated
08/18/2016
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