Provider Demographics
NPI:1235807785
Name:STAHLI, JENNIFER M
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:STAHLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5417
Mailing Address - Country:US
Mailing Address - Phone:845-728-9804
Mailing Address - Fax:
Practice Address - Street 1:228 WARD ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1270
Practice Address - Country:US
Practice Address - Phone:845-293-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist