Provider Demographics
NPI:1053566844
Name:GIARDINI, JACQUELINE M (MS, CCC-LSLP)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:M
Last Name:GIARDINI
Suffix:
Gender:F
Credentials:MS, CCC-LSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3639 MCCLURE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9628
Mailing Address - Country:US
Mailing Address - Phone:716-373-4730
Mailing Address - Fax:
Practice Address - Street 1:3639 MCCLURE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ALLEGANY
Practice Address - State:NY
Practice Address - Zip Code:14706-9628
Practice Address - Country:US
Practice Address - Phone:716-373-4730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0084271235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist