Doctor Name: | MS. JEAN M MASSARO |
NPI Number: | 1588964571 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC, SLP |
License Number: | 41YS00116400 |
Business Practice Address: | 12 Forest Knoll Dr Suffern, NY - 109017638 |
Business Phone Number: | 8453683585 |
Business Fax Number: | |
Mailing Address: | 12 Forest Knoll Dr, SUFFERN |
State: | NY |
Postal Code: | 109017638 |
Phone Number: | 8453683585 |
Fax Number: | |
NPI Enumeration Date: | 10/25/2010 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 41YS00116400 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
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 |