Provider Demographics
NPI:1356576235
Name:SORELL, JEANNIE FRANCES (MA CCC)
Entity type:Individual
Prefix:MS
First Name:JEANNIE
Middle Name:FRANCES
Last Name:SORELL
Suffix:
Gender:F
Credentials:MA CCC
Other - Prefix:
Other - First Name:JEANNIE
Other - Middle Name:FRANCES
Other - Last Name:MIGNONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1609
Mailing Address - Country:US
Mailing Address - Phone:914-232-1842
Mailing Address - Fax:
Practice Address - Street 1:47 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1609
Practice Address - Country:US
Practice Address - Phone:914-232-1842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003420235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist