Provider Demographics
NPI:1598062044
Name:NUNEZ, JASMINE R (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:R
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1401
Mailing Address - Country:US
Mailing Address - Phone:845-267-2500
Mailing Address - Fax:845-267-2591
Practice Address - Street 1:25 HEMLOCK DR
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1401
Practice Address - Country:US
Practice Address - Phone:845-267-2500
Practice Address - Fax:845-267-2591
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist