National Provider Identifier
Jessica Marie D'Agostino
Jessica Marie D'Agostino is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Victor, NY and a listed phone number of (585) 924-7207.
Profile Overview
- NPI
- 1497005425
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- September 18, 2012
- Last Updated
- July 07, 2020
Practice Location
- 590 Fishers Station Dr
- Suite 130
- Victor, NY 14564-9744
Phone: (585) 924-7207
Mailing Address
- 16931 Grissom Dr
- Tinley Park, IL 60477-2698
Specialties
- Speech-Language Pathologist (235Z00000X)
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1497005425
- Entity Type
- Individual
- Last Name
- D'Agostino
- First Name
- Jessica
- Middle Name
- Marie
- Mailing Street Address
- 16931 Grissom Dr
- Mailing City
- Tinley Park
- Mailing State
- IL
- Mailing ZIP Code
- 60477-2698
- Mailing Country
- US
- Practice Street Address
- 590 Fishers Station Dr
- Practice Address Line 2
- Suite 130
- Practice City
- Victor
- Practice State
- NY
- Practice ZIP Code
- 14564-9744
- Practice Country
- US
- Practice Phone
- (585) 924-7207
- Practice Fax
- (585) 924-7049
- Enumeration Date
- September 18, 2012
- Last Updated
- July 07, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- July 07, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X), Speech-Language Pathologist (235Z00000X)