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Jessica Gonzalez Dianora, CCC-SLP

Speech-Language Pathologist, in New York, NY. Individual provider (NPI-1).

NPI number1003359639
StatusActive
Last updated in NPPESJan 11, 2022

Details

NPI
1003359639
Entity type
Individual (NPI-1)
Name
Ms. Jessica Gonzalez Dianora
Credential
CCC-SLP
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 30, 2016
Certification date
Nov 22, 2021
Last updated
Jan 11, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,026166NYYes

Practice location

123 Ridge St
New York, NY 10002-2509

Phone 212-677-4680

Mailing address

123 Ridge St
New York, NY 10002-2509

Phone 212-677-4680

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