Provider Demographics
NPI:1588959746
Name:CORTINA, JESSICA ANN
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:CORTINA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 N PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1628
Mailing Address - Country:US
Mailing Address - Phone:585-325-2255
Mailing Address - Fax:585-935-7405
Practice Address - Street 1:555 N PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1628
Practice Address - Country:US
Practice Address - Phone:585-325-2255
Practice Address - Fax:585-935-7405
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist