Provider Demographics
NPI:1548403405
Name:LARRIU, JANNELLY (SLP/TSSLD)
Entity Type:Individual
Prefix:MISS
First Name:JANNELLY
Middle Name:
Last Name:LARRIU
Suffix:
Gender:F
Credentials:SLP/TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BENCHLEY PL
Mailing Address - Street 2:APT 19G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3402
Mailing Address - Country:US
Mailing Address - Phone:646-479-0571
Mailing Address - Fax:
Practice Address - Street 1:120 BENCHLEY PL
Practice Address - Street 2:APT 19G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3402
Practice Address - Country:US
Practice Address - Phone:646-479-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018897235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist