Provider Demographics
NPI:1871865808
Name:LIMING, JESSICA RUTH (MA SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RUTH
Last Name:LIMING
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3327
Mailing Address - Country:US
Mailing Address - Phone:585-752-8645
Mailing Address - Fax:
Practice Address - Street 1:35 BROOKSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:MUMFORD
Practice Address - State:NY
Practice Address - Zip Code:14511
Practice Address - Country:US
Practice Address - Phone:585-752-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist