Provider Demographics
NPI:1407013329
Name:PELLETTER, LAYNA B (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAYNA
Middle Name:B
Last Name:PELLETTER
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KAREN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:14136-1320
Mailing Address - Country:US
Mailing Address - Phone:716-934-2016
Mailing Address - Fax:
Practice Address - Street 1:2 KAREN DR
Practice Address - Street 2:
Practice Address - City:SILVER CREEK
Practice Address - State:NY
Practice Address - Zip Code:14136-1320
Practice Address - Country:US
Practice Address - Phone:716-934-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007665-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist