Most Relevant Information
Provider Data
| NPI Number: | 1003359639 |
| Provider Name: | JESSICA GONZALEZ DIANORA CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 026166 |
Most Important Dates
| Enumeration Date: | 11/30/2016 |
| Last Updated: | 01/11/2022 |
Provider Practice Location
123 RIDGE ST
NEW YORK
NY
100022509
Practice Location Phone/Fax
| Phone: | 2126774680 |
| Fax: |
Provider Mailing Location
123 RIDGE ST
NEW YORK
NY
100022509
Provider Mailing Phone/Fax
| Phone: | 2126774680 |
| Fax: |