Provider Demographics
NPI:1831491356
Name:SIEPIERSKI, JENNIFER ANNE (MS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANNE
Last Name:SIEPIERSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 W BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-1242
Mailing Address - Country:US
Mailing Address - Phone:585-786-8000
Mailing Address - Fax:
Practice Address - Street 1:153 W BUFFALO ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1242
Practice Address - Country:US
Practice Address - Phone:585-786-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01133216OtherAMERICAN SPEECH- LANGUAGE-HEARING ASSOCIATION
NY008786OtherSTATE EDUCATION DEPARTMENT