Provider Demographics
NPI:1124542493
Name:CALABRESE, JENA A (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:A
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:A
Other - Last Name:TERRANOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:211 SATINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1929
Mailing Address - Country:US
Mailing Address - Phone:732-778-0830
Mailing Address - Fax:
Practice Address - Street 1:500 ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5038
Practice Address - Country:US
Practice Address - Phone:732-778-0380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist