Provider Demographics
NPI:1992263651
Name:TOLINO, JESSICA (SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TOLINO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 GREENVALE PKWY
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2546
Mailing Address - Country:US
Mailing Address - Phone:609-319-6262
Mailing Address - Fax:
Practice Address - Street 1:2600 VIRGINIA AVE NW STE 900
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1930
Practice Address - Country:US
Practice Address - Phone:202-265-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08764235Z00000X
DCSLP001364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist