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NPI Code Detail

MEDICARE: JENESSA SIENA

MEDICARE:   JENESSA  SIENA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist146011151IL

General Provider Information

NPI Number : 1235657230
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENESSA SIENA
Provider Business Mailing Address
First Line : 418 SANGAMON RD
Second Line :
City : MARQUETTE HEIGHTS
State : IL
Zip : 61554-1255
Country : US
Telephone Number : 309-267-8838
Fax Number :
Provider Business Practice Location Address
First Line : 418 SANGAMON RD
Second Line :
City : MARQUETTE HEIGHTS
State : IL
Zip : 61554-1255
Country : US
Telephone Number : 309-267-8838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 07/21/2022

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Directions to “ JENESSA SIENA ” Practice Location

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