Provider Demographics
NPI:1578836813
Name:REICH, JESSICA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:REICH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WESTGATE RD
Mailing Address - Street 2:APT E
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5026
Mailing Address - Country:US
Mailing Address - Phone:201-280-1411
Mailing Address - Fax:
Practice Address - Street 1:24 WESTGATE RD
Practice Address - Street 2:APT E
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5026
Practice Address - Country:US
Practice Address - Phone:201-280-1411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021616-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist