Jaely Manso

Individual provider Active NPI Speech-Language Pathologist · Windsor Locks, CT

NPI 1144098237 · NPPES record last updated Dec 18, 2023

Key facts

NPI
1144098237
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
14 Main St
Windsor Locks, CT 06096-2307
Phone
(860) 856-0739
NPI assigned
Dec 18, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

14 Main St
Windsor Locks, CT 06096-2307

Mailing address

14 Main St
Windsor Locks, CT 06096-2307
Phone (860) 856-0739

Other providers in Windsor Locks, CT

All providers in Windsor Locks, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.