Provider Demographics
NPI:1255798807
Name:AMORESE, JESSIE LYNN
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:LYNN
Last Name:AMORESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:
Other - Last Name:EICHELSBACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-1132
Mailing Address - Country:US
Mailing Address - Phone:585-355-5048
Mailing Address - Fax:
Practice Address - Street 1:85 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-1132
Practice Address - Country:US
Practice Address - Phone:585-355-5048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist