Jessica L Ackerman, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Stoughton, MA

NPI 1104045186 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104045186
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
6301 (MA)
Practice address
150 York St
Stoughton, MA 02072-1829
Phone
(781) 297-1420
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6301 MA Yes

Addresses

Primary practice location

150 York St
Stoughton, MA 02072-1829

Mailing address

2207 Washington St
#2
Canton, MA 02021-1155
Phone (781) 571-9417

Other names

  • Jessica L Defalco Former name

Other providers in Stoughton, MA

All providers in Stoughton, MA · Speech-Language Pathologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.