Provider Demographics
NPI:1790026318
Name:MARCHESE, JENNIFER LESLIE (MA, NYSL-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LESLIE
Last Name:MARCHESE
Suffix:
Gender:F
Credentials:MA, NYSL-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1884 HARDY CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14737-9760
Mailing Address - Country:US
Mailing Address - Phone:716-946-8736
Mailing Address - Fax:716-662-5700
Practice Address - Street 1:6167 W QUAKER ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2640
Practice Address - Country:US
Practice Address - Phone:716-662-4800
Practice Address - Fax:716-662-5700
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY023301-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist