Provider Demographics
NPI:1932350923
Name:SITLER-REDPATH, JENNIFER (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SITLER-REDPATH
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 1:462 BEACH 141ST ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1247
Mailing Address - Country:US
Mailing Address - Phone:718-318-1620
Mailing Address - Fax:718-318-5166
Practice Address - Street 1:462 BEACH 141ST ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1247
Practice Address - Country:US
Practice Address - Phone:718-318-1620
Practice Address - Fax:718-318-5166
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012978-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist