Provider Demographics
NPI:1760582753
Name:TOPPER, JEANETTE (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:
Last Name:TOPPER
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 1:9655 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870-9085
Mailing Address - Country:US
Mailing Address - Phone:716-548-8988
Mailing Address - Fax:
Practice Address - Street 1:8272 MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:HAMMONDSPORT
Practice Address - State:NY
Practice Address - Zip Code:14840-9701
Practice Address - Country:US
Practice Address - Phone:607-569-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0911235Z00000X
NC5774235Z00000X
NY009225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist