Provider Demographics
NPI:1295416824
Name:CHEN, JESSICA (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 SOUTH 1530 EAST
Mailing Address - Street 2:SUITE 1217 A BEH S
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112
Mailing Address - Country:US
Mailing Address - Phone:801-581-3506
Mailing Address - Fax:
Practice Address - Street 1:417 WAKARA WAY
Practice Address - Street 2:SUITE 1112
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-8411
Practice Address - Country:US
Practice Address - Phone:801-581-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist