Provider Demographics
NPI:1144797150
Name:OSTRANDER, CELINA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:OSTRANDER
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 1:11868 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:CHAUMONT
Mailing Address - State:NY
Mailing Address - Zip Code:13622-7709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11868 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:CHAUMONT
Practice Address - State:NY
Practice Address - Zip Code:13622-7709
Practice Address - Country:US
Practice Address - Phone:315-649-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist