Provider Demographics
NPI:1770728958
Name:PALIAN, JESSIE M (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:M
Last Name:PALIAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-3042
Mailing Address - Country:US
Mailing Address - Phone:917-715-9658
Mailing Address - Fax:
Practice Address - Street 1:1585 MILITARY TPKE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-7457
Practice Address - Country:US
Practice Address - Phone:518-561-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist