Provider Demographics
NPI:1568751626
Name:MCPHATTER, JENAE C (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JENAE
Middle Name:C
Last Name:MCPHATTER
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 1:1 VAN DER DONCK ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-7049
Mailing Address - Country:US
Mailing Address - Phone:917-449-9321
Mailing Address - Fax:
Practice Address - Street 1:1 VAN DER DONCK ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-7049
Practice Address - Country:US
Practice Address - Phone:917-449-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist