Provider Demographics
NPI:1588801971
Name:KREBSER, JEANMARIE (MS ED CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:JEANMARIE
Middle Name:
Last Name:KREBSER
Suffix:
Gender:F
Credentials:MS ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CORNWALL MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-2651
Mailing Address - Country:US
Mailing Address - Phone:845-489-5788
Mailing Address - Fax:
Practice Address - Street 1:325 CORNWALL MEADOWS LN
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:NY
Practice Address - Zip Code:12563-2651
Practice Address - Country:US
Practice Address - Phone:845-489-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012264-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist