Provider Demographics
NPI:1356594907
Name:ANICITO, JENNIFER HANSER (MS, CCC-SLP TSHH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HANSER
Last Name:ANICITO
Suffix:
Gender:F
Credentials:MS, CCC-SLP TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CLOVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6205
Mailing Address - Country:US
Mailing Address - Phone:917-816-0838
Mailing Address - Fax:
Practice Address - Street 1:8 CLOVERHILL DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6205
Practice Address - Country:US
Practice Address - Phone:917-816-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012831-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist