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Individual

MRS. JESSICA ROSE BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A. CCC-SLP, CBIS

Contact information

Practice address
18-01 POLLITT DR, FAIR LAWN, NJ 07410-2813
(201) 478-4200
Mailing address
18-01 POLLITT DR, FAIR LAWN, NJ 07410-2813
(201) 478-4200

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
018746-1
NY
235Z00000X
Speech-Language Pathologist
Primary
41YS00588300
NJ

Other

Enumeration date
11/16/2011
Last updated
03/27/2012
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