Provider Demographics
NPI:1134366826
Name:DRISCOLL, PATRICIA M (MS, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:MONTANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC, SLP
Mailing Address - Street 1:170 INTREPID LANE
Mailing Address - Street 2:HIGH PEAKS REHABILITATION & DEVELOPMENT
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 1:170 INTREPID LANE
Practice Address - Street 2:HIGH PEAKS REHABILITATION & DEVELOPMENT
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205
Practice Address - Country:US
Practice Address - Phone:315-492-8319
Practice Address - Fax:315-492-3758
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005653-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist