Individual
JODI MARIE BANIUKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
335 CHANDLER ST, WORCESTER, MA 01602-3441
(508) 753-2967
(508) 767-3095
Mailing address
335 CHANDLER ST, WORCESTER, MA 01602-3441
(508) 753-2967
(508) 767-3095
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-7570-SL
MA
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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