Provider Demographics
NPI:1366869851
Name:SIKORA, CHAMONIX (MS, CCC-SLP, BCS-F)
Entity Type:Individual
Prefix:MRS
First Name:CHAMONIX
Middle Name:
Last Name:SIKORA
Suffix:
Gender:F
Credentials:MS, CCC-SLP, BCS-F
Other - Prefix:
Other - First Name:CHAMONIX
Other - Middle Name:
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8B CHURCH STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:917-494-0725
Mailing Address - Fax:
Practice Address - Street 1:8B CHURCH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:917-494-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003317235Z00000X
NY013479235Z00000X
MASP-9073-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist