Provider Demographics
NPI:1154811263
Name:CROTEAU, JESSIE
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:CROTEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ELMHURST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-2612
Mailing Address - Country:US
Mailing Address - Phone:401-787-0037
Mailing Address - Fax:
Practice Address - Street 1:8 ELMHURST DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-2612
Practice Address - Country:US
Practice Address - Phone:401-787-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist