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General NPI Number Information
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NPI Number | 1417555285
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Entity Type | Individual
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Provider Name | JACQUELINE YALE GIORDANO M.S. CCC-SLP (CT&NY)
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Gender | Female
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 420 E MAIN ST STE 13
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City | BRANFORD
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State | CT
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Zip | 06405-2942
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Country | US
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Telephone | 203-481-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MEADOW PL
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City | EAST HAVEN
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State | CT
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Zip | 06512-4790
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Country | US
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Telephone | 203-448-7768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 030240
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18.005956
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License Number State | CT
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