Provider Demographics
NPI:1992939649
Name:DUFFY, KERRIANN (MS,CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KERRIANN
Middle Name:
Last Name:DUFFY
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 1:800 STILLWATER RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-1821
Mailing Address - Country:US
Mailing Address - Phone:203-977-6631
Mailing Address - Fax:
Practice Address - Street 1:800 STILLWATER RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-1821
Practice Address - Country:US
Practice Address - Phone:203-977-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist