Provider Demographics
NPI:1902118078
Name:CARNEY-NESBITT, SIOBHAN M (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SIOBHAN
Middle Name:M
Last Name:CARNEY-NESBITT
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 1:1 RAPP RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-4491
Mailing Address - Country:US
Mailing Address - Phone:518-867-3061
Mailing Address - Fax:518-867-3066
Practice Address - Street 1:6 FERRIS DR
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-9142
Practice Address - Country:US
Practice Address - Phone:518-852-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018219-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist