Provider Demographics
NPI:1679727051
Name:KNECHTEL, JACLYN YVONNE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:YVONNE
Last Name:KNECHTEL
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 60TH ST
Mailing Address - Street 2:7G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1406
Mailing Address - Country:US
Mailing Address - Phone:917-292-8763
Mailing Address - Fax:
Practice Address - Street 1:220 E 60TH ST
Practice Address - Street 2:7G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1406
Practice Address - Country:US
Practice Address - Phone:917-292-8763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist