Provider Demographics
NPI:1821245879
Name:SUKTE, CIINKHANMAAN HAUGO
Entity Type:Individual
Prefix:MS
First Name:CIINKHANMAAN
Middle Name:HAUGO
Last Name:SUKTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAAN
Other - Middle Name:
Other - Last Name:SUKTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:142 N. WAYNE AVE.
Mailing Address - Street 2:305
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087
Mailing Address - Country:US
Mailing Address - Phone:610-213-0734
Mailing Address - Fax:610-995-2135
Practice Address - Street 1:412 N WAYNE AVE
Practice Address - Street 2:305
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3248
Practice Address - Country:US
Practice Address - Phone:610-213-0734
Practice Address - Fax:610-995-2135
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist