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Individual
MRS. JESSICA L GROUP
Active
Individual
MRS. JESSICA L GROUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S SLP/CCC-L
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012836
NY
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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