Provider Demographics
NPI:1821769001
Name:TORRES SERRANT, JEANETTE VANESSA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:VANESSA
Last Name:TORRES SERRANT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2190 PONCE BY PASS
Mailing Address - Street 2:URB INDUSTRIAL REPARADA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-844-4628
Mailing Address - Fax:
Practice Address - Street 1:URB INDUSTRIAL REPARADA
Practice Address - Street 2:2188 LOCAL A SUITE A PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-844-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000331235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist