National Provider Identifier
Jayne Marie Hettenbaugh, M.A.CCC-SLP
Jayne Marie Hettenbaugh, M.A.CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Randolph, NY and a listed phone number of (716) 358-9236.
Profile Overview
- NPI
- 1912152463
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- November 25, 2008
- Last Updated
- November 25, 2008
Practice Location
- 126 Larkin Street Ext
- Randolph, NY 14772-9651
Phone: (716) 358-9236
Mailing Address
- P.O.Box 53
- 126 Larkin Street
- Randolph, NY 14772-0053
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1912152463
- Entity Type
- Individual
- Last Name
- Hettenbaugh
- First Name
- Jayne
- Middle Name
- Marie
- Credential
- M.A.CCC-SLP
- Mailing Street Address
- P.O.Box 53
- Mailing Address Line 2
- 126 Larkin Street
- Mailing City
- Randolph
- Mailing State
- NY
- Mailing ZIP Code
- 14772-0053
- Mailing Country
- US
- Mailing Phone
- (716) 358-9236
- Practice Street Address
- 126 Larkin Street Ext
- Practice City
- Randolph
- Practice State
- NY
- Practice ZIP Code
- 14772-9651
- Practice Country
- US
- Practice Phone
- (716) 358-9236
- Enumeration Date
- November 25, 2008
- Last Updated
- November 25, 2008
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)