Individual
JACQUELINE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1731 BEACON ST APT 704, BROOKLINE, MA 02445-5326
(845) 857-4953
Mailing address
1731 BEACON ST APT 704, BROOKLINE, MA 02445-5326
(845) 857-4953
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
030372
NY
235Z00000X
Speech-Language Pathologist
Primary
78260
MA
Other
Enumeration date
08/07/2019
Last updated
11/04/2022
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