Provider Demographics
NPI:1487992152
Name:HOURDAS, JESSICA GRACE (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GRACE
Last Name:HOURDAS
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7657 CITA LN
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6221
Mailing Address - Country:US
Mailing Address - Phone:727-376-1111
Mailing Address - Fax:727-376-1113
Practice Address - Street 1:7657 CITA LN
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6221
Practice Address - Country:US
Practice Address - Phone:727-376-1111
Practice Address - Fax:727-376-1113
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist