Provider Demographics
NPI:1942732565
Name:CALO, JACLYN (CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:
Last Name:CALO
Suffix:
Gender:F
Credentials:CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:GIGANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2836 FALLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2906
Mailing Address - Country:US
Mailing Address - Phone:516-508-8521
Mailing Address - Fax:
Practice Address - Street 1:2836 FALLWOOD CT
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2906
Practice Address - Country:US
Practice Address - Phone:516-508-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist