Provider Demographics
NPI:1730495862
Name:KERSTING, STEPHANIE M (MS)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:KERSTING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:LAVIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 HILLVIEW DR E
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-4704
Mailing Address - Country:US
Mailing Address - Phone:203-546-8552
Mailing Address - Fax:
Practice Address - Street 1:1938 ROUTE 6
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2311
Practice Address - Country:US
Practice Address - Phone:845-225-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011562235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist