Provider Demographics
NPI:1023397601
Name:MASCIARELLI, JESSICA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MASCIARELLI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 JOSIAH DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-4248
Mailing Address - Country:US
Mailing Address - Phone:919-763-5703
Mailing Address - Fax:919-243-8229
Practice Address - Street 1:311 JOSIAH DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-4248
Practice Address - Country:US
Practice Address - Phone:919-763-5703
Practice Address - Fax:919-243-8229
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist