Provider Demographics
NPI:1861893398
Name:SPENNACCHIO, JENNINE MICHELLE (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:JENNINE
Middle Name:MICHELLE
Last Name:SPENNACCHIO
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PITCHER RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5186
Mailing Address - Country:US
Mailing Address - Phone:845-242-7461
Mailing Address - Fax:
Practice Address - Street 1:822 NY-82
Practice Address - Street 2:SUITE 330
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533
Practice Address - Country:US
Practice Address - Phone:845-242-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist