| NPI | 1114420890 |
|---|---|
| Former Name | JESSICA ANN BAGBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 168247) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 08537) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2024-04-01 |