Provider Demographics
NPI:1568632552
Name:SCIRTO, KATIE LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:LYNN
Last Name:SCIRTO
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 1:5220 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9464
Mailing Address - Country:US
Mailing Address - Phone:716-439-9617
Mailing Address - Fax:
Practice Address - Street 1:5220 RANDOLPH STREET
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132
Practice Address - Country:US
Practice Address - Phone:716-439-9617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013742-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist