Individual
JENNIFER FEDERICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
79 MONTCLAIR AVE, MONTCLAIR, NJ 07042-4128
(646) 571-8393
Mailing address
79 MONTCLAIR AVE, MONTCLAIR, NJ 07042-4128
(646) 571-8393
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01047400
NJ
Other
Enumeration date
09/21/2020
Last updated
04/23/2021
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