Individual
JESSICA MARIE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.H.S CCC-SLP
Contact information
Practice address
12938 COLDWATER RD, FORT WAYNE, IN 46845-9517
(260) 245-1455
Mailing address
12938 COLDWATER RD, FORT WAYNE, IN 46845-9517
(260) 245-1455
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242005700
IL
Other
Enumeration date
11/25/2020
Last updated
05/07/2021
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