Provider Demographics
NPI:1265725378
Name:CELONA, JENNIFER MICHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:CELONA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MICHELLE
Other - Last Name:PERRIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:111 PASSAIC AVE
Mailing Address - Street 2:APT. A-13
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3818
Mailing Address - Country:US
Mailing Address - Phone:484-888-6459
Mailing Address - Fax:
Practice Address - Street 1:315 E LINDSLEY RD
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1152
Practice Address - Country:US
Practice Address - Phone:973-754-4801
Practice Address - Fax:973-785-2134
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00637400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist