Individual
JESSICA LEIGH MATTIACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 HERZEL AVE, NORTHFIELD, NJ 08225-1237
(609) 425-9182
Mailing address
605 HERZEL AVE, NORTHFIELD, NJ 08225-1237
(609) 425-9182
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12124313
NJ
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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