Provider Demographics
NPI:1417248220
Name:COUNT, VICKI JEANNE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:JEANNE
Last Name:COUNT
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:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:NEW LEBANON
Mailing Address - State:NY
Mailing Address - Zip Code:12125-0648
Mailing Address - Country:US
Mailing Address - Phone:518-794-9489
Mailing Address - Fax:
Practice Address - Street 1:1478 ROUTE 20
Practice Address - Street 2:WALTER B HOWARD ELEMENTARY SCHOOL
Practice Address - City:NEW LEBANON
Practice Address - State:NY
Practice Address - Zip Code:12125-1478
Practice Address - Country:US
Practice Address - Phone:518-794-8554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009803-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist