Provider Demographics
NPI:1467634568
Name:TORRELLA, JEANETTE MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:MARIE
Last Name:TORRELLA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18441 SW 224TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-3504
Mailing Address - Country:US
Mailing Address - Phone:786-999-2399
Mailing Address - Fax:
Practice Address - Street 1:1380 N KROME AVE STE 110
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2406
Practice Address - Country:US
Practice Address - Phone:305-247-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9007235Z00000X
FLSA14582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist