Provider Demographics
NPI:1649800939
Name:D'ARGENIO, JACLYN (SLP)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:D'ARGENIO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BOULEVARD AVE
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-2222
Mailing Address - Country:US
Mailing Address - Phone:856-425-8844
Mailing Address - Fax:
Practice Address - Street 1:215 BOULEVARD AVE
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-2222
Practice Address - Country:US
Practice Address - Phone:856-425-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10382235Z00000X
NJ41YS01041300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist