Provider Demographics
NPI:1033401112
Name:GRECCO, JACQUELIN SPRING (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELIN
Middle Name:SPRING
Last Name:GRECCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 UNIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3532
Mailing Address - Country:US
Mailing Address - Phone:724-316-5797
Mailing Address - Fax:
Practice Address - Street 1:9800B MCKNIGHT RD
Practice Address - Street 2:SUITE 150/228
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-364-2446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001144L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist