Provider Demographics
NPI:1083127450
Name:CORRING, JESSICA MICHELE (MS-CCC SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MICHELE
Last Name:CORRING
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 1:634 HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-4716
Mailing Address - Country:US
Mailing Address - Phone:732-687-6937
Mailing Address - Fax:
Practice Address - Street 1:213 BENJAMIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1473
Practice Address - Country:US
Practice Address - Phone:732-886-6996
Practice Address - Fax:732-866-8862
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00523100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist