Doctor Name: | MRS. JADE ALEXA ADDONISIO |
NPI Number: | 1588932537 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. S. CCC-SLP |
License Number: | 2365508 |
Business Practice Address: | 8 Raffaella Dr Eastport, NY - 119411446 |
Business Phone Number: | 6314337788 |
Business Fax Number: | |
Mailing Address: | 8 Raffaella Dr, EASTPORT |
State: | NY |
Postal Code: | 119411446 |
Phone Number: | 6314337788 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2011 |
NPI Last Update Date: | 08/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2365508 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |