Jessica Rae Derrick, M.S.,CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Carthage, TX
NPI 1477035988 · NPPES record last updated Aug 30, 2018
Key facts
- NPI
- 1477035988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 111344 (TX)
- Practice address
- 853 County Road 490
Carthage, TX 75633-3304 - Phone
- (903) 754-0061
- NPI assigned
- Aug 30, 2018
- 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)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111344 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 111344 | TX | Yes |
Addresses
Primary practice location
853 County Road 490
Carthage, TX 75633-3304
Mailing address
853 County Road 490
Carthage, TX 75633-3304
Other providers in Carthage, TX
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- Brenda Carol Daum
- Rebecca Evelyn Davis
- Dennis D Golden OD PC Inc
- Ben B Donald II
- Susan Giroux Donald
- Emily Dunn
- Adam Duran
- East Texas Medical Center Carthage
All providers in Carthage, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.