Individual
JACQUELINE DIEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
53 SALEM LANE, LITTLE SILVER, NJ 07739
(732) 936-9151
Mailing address
53 SALEM LANE, LITTLE SILVER, NJ 07739
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00423100
NJ
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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