Provider Demographics
NPI:1285114744
Name:CADENA, JESSY MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:JESSY
Middle Name:MARIE
Last Name:CADENA
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 1:10113 UP RIVER RD APT 4301
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-1511
Mailing Address - Country:US
Mailing Address - Phone:956-532-6326
Mailing Address - Fax:
Practice Address - Street 1:2735 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3306
Practice Address - Country:US
Practice Address - Phone:361-992-0816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist