Provider Demographics
NPI:1831747385
Name:KNAPP, KEARSTIN E (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KEARSTIN
Middle Name:E
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10342 HOTALING RD
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-9564
Mailing Address - Country:US
Mailing Address - Phone:585-975-9343
Mailing Address - Fax:
Practice Address - Street 1:10342 HOTALING RD
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9564
Practice Address - Country:US
Practice Address - Phone:585-975-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty