Provider Demographics
NPI:1376263566
Name:GIALLORETO, JENNA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:GIALLORETO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIVERSITY
Mailing Address - State:PA
Mailing Address - Zip Code:19352-8940
Mailing Address - Country:US
Mailing Address - Phone:302-388-3079
Mailing Address - Fax:
Practice Address - Street 1:313 S 5TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:DE
Practice Address - Zip Code:19730-2078
Practice Address - Country:US
Practice Address - Phone:302-378-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0012113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist