Provider Demographics
NPI:1982090155
Name:RUCCI, ANNE KIERSTIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:KIERSTIE
Last Name:RUCCI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:KIERSTIE
Other - Middle Name:
Other - Last Name:RUCCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:9 PRESCOTT SQ
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2206
Mailing Address - Country:US
Mailing Address - Phone:917-743-3699
Mailing Address - Fax:
Practice Address - Street 1:9 PRESCOTT SQ
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2206
Practice Address - Country:US
Practice Address - Phone:917-743-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12078244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist