Provider Demographics
NPI:1720355449
Name:TINELLI, CARI DAWN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARI
Middle Name:DAWN
Last Name:TINELLI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9762
Mailing Address - Country:US
Mailing Address - Phone:315-418-0881
Mailing Address - Fax:
Practice Address - Street 1:416 E RAYNOR AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3951
Practice Address - Country:US
Practice Address - Phone:315-476-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9671235Z00000X
NY027189-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist