Provider Demographics
NPI:1871732545
Name:PARTHASARATHY, JESSICA L (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:PARTHASARATHY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20716 CRYSTAL HILL CIR
Mailing Address - Street 2:APT. B
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3955
Mailing Address - Country:US
Mailing Address - Phone:845-454-2673
Mailing Address - Fax:
Practice Address - Street 1:20716 CRYSTAL HILL CIR
Practice Address - Street 2:APT. B
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-3955
Practice Address - Country:US
Practice Address - Phone:845-454-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist