Provider Demographics
NPI:1073906061
Name:ROMANS, JESSICA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:ROMANS
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 DANBY RD STE 202T
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5714
Mailing Address - Country:US
Mailing Address - Phone:607-331-3454
Mailing Address - Fax:
Practice Address - Street 1:950 DANBY RD STE 202T
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5714
Practice Address - Country:US
Practice Address - Phone:607-331-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-15
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030976235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist