Provider Demographics
NPI:1093430035
Name:DEGRANGE, JAILESCI MARIA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAILESCI
Middle Name:MARIA
Last Name:DEGRANGE
Suffix:
Gender:F
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 1:301 E HOUSE ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3545
Mailing Address - Country:US
Mailing Address - Phone:281-245-3267
Mailing Address - Fax:
Practice Address - Street 1:301 E HOUSE ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3545
Practice Address - Country:US
Practice Address - Phone:281-245-3267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist