Provider Demographics
NPI:1649036658
Name:FRATONI-JASKIEWICZ, BRIELLE LYNN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:BRIELLE
Middle Name:LYNN
Last Name:FRATONI-JASKIEWICZ
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1320
Mailing Address - Country:US
Mailing Address - Phone:860-938-5757
Mailing Address - Fax:
Practice Address - Street 1:161 COMSTOCK PKWY
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02921-2002
Practice Address - Country:US
Practice Address - Phone:401-463-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00613-P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist