Provider Demographics
NPI:1184881286
Name:KUCZENSKI, JANE MARIE (CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MARIE
Last Name:KUCZENSKI
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-3145
Mailing Address - Country:US
Mailing Address - Phone:716-366-6973
Mailing Address - Fax:
Practice Address - Street 1:1020 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-3421
Practice Address - Country:US
Practice Address - Phone:716-366-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006925-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist