Provider Demographics
NPI:1952430712
Name:AMMONDS, KIA ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KIA
Middle Name:ANN
Last Name:AMMONDS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LOIS LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-6701
Mailing Address - Country:US
Mailing Address - Phone:516-293-1315
Mailing Address - Fax:
Practice Address - Street 1:36 LOIS LN
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-6701
Practice Address - Country:US
Practice Address - Phone:516-293-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009161-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist