Provider Demographics
NPI:1831952514
Name:RICH, JESSICA LOVELAND (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LOVELAND
Last Name:RICH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 LAMP LIGHTER LN
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1951
Mailing Address - Country:US
Mailing Address - Phone:904-687-4000
Mailing Address - Fax:
Practice Address - Street 1:8929 R G SKINNER PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9724
Practice Address - Country:US
Practice Address - Phone:904-513-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist