Jenna Marie Restivo, M.A.-SLP
Speech-Language Pathologist, in Staten Island, NY. Individual provider (NPI-1).
NPI number1760655880
StatusActive
Last updated in NPPESJan 8, 2020
Details
- NPI
- 1760655880
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jenna Marie Restivo
- Credential
- M.A.-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 9, 2008
- Certification date
- Jan 8, 2020
- Last updated
- Jan 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 018067-1 | NY | Yes |
Practice location
28 Maybury CtStaten Island, NY 10306-3613
Phone 718-554-4777
Mailing address
7 Rogers PlStaten Island, NY 10312-4119
Phone 917-881-2069
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