Provider Demographics
NPI:1962657601
Name:KNIPE, KATHRYN EMILY (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:EMILY
Last Name:KNIPE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:EMILY
Other - Last Name:RUSIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 INTREPID LANE
Mailing Address - Street 2:HIGH PEAKS
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205
Mailing Address - Country:US
Mailing Address - Phone:315-492-8319
Mailing Address - Fax:315-492-3758
Practice Address - Street 1:29 EAST ONEIDA STREET
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027
Practice Address - Country:US
Practice Address - Phone:315-638-6121
Practice Address - Fax:315-492-3758
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017505-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist