Individual
JESSICA MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3506
(203) 384-8681
(203) 384-0722
Mailing address
1931 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3506
(203) 384-8681
(203) 384-0722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004737
CT
Other
Enumeration date
09/26/2013
Last updated
01/03/2020
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