Provider Demographics
NPI:1275869851
Name:SECKNER, CASEY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:
Last Name:SECKNER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 COUNTY ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:PARISH
Mailing Address - State:NY
Mailing Address - Zip Code:13131-3178
Mailing Address - Country:US
Mailing Address - Phone:315-345-7342
Mailing Address - Fax:
Practice Address - Street 1:483 COUNTY ROUTE 22
Practice Address - Street 2:
Practice Address - City:PARISH
Practice Address - State:NY
Practice Address - Zip Code:13131-3178
Practice Address - Country:US
Practice Address - Phone:315-345-7342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist