Doctor Name: | MS. JESSICA BRACERO |
NPI Number: | 1144578857 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SL011855 |
Business Practice Address: | 52 Hamilton Cir Philadelphia, PA - 191303822 |
Business Phone Number: | 5185690283 |
Business Fax Number: | |
Mailing Address: | 52 Hamilton Cir, PHILADELPHIA |
State: | PA |
Postal Code: | 191303822 |
Phone Number: | 5185690283 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2012 |
NPI Last Update Date: | 09/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL011855 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |