Provider Demographics
NPI:1548937352
Name:TARIO, VANESSA A (MS, CCC, SLP)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:A
Last Name:TARIO
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:A
Other - Last Name:MONSERRAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC,S LP
Mailing Address - Street 1:16-03 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2710
Mailing Address - Country:US
Mailing Address - Phone:201-994-6343
Mailing Address - Fax:
Practice Address - Street 1:600 VALLEY RD STE 206A
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3551
Practice Address - Country:US
Practice Address - Phone:315-889-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1138621235Z00000X
NJ41YS01077300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist