Individual
JAVIER JASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
3901 MANAYUNK AVE APT 126, PHILADELPHIA, PA 19128-5124
(209) 613-0868
Mailing address
3901 MANAYUNK AVE APT 126, PHILADELPHIA, PA 19128-5124
(209) 613-0868
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL014828
PA
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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