Provider Demographics
NPI:1811142243
Name:KESLONSKY, JAIME L (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:L
Last Name:KESLONSKY
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 1:14 SEVENOAKE RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3927
Mailing Address - Country:US
Mailing Address - Phone:631-920-0767
Mailing Address - Fax:
Practice Address - Street 1:14 SEVENOAKE RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3927
Practice Address - Country:US
Practice Address - Phone:631-920-0767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013826235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist