Provider Demographics
NPI:1053624726
Name:KUTTIYARA, JENNY JAMES (MS TSSLD)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:JAMES
Last Name:KUTTIYARA
Suffix:
Gender:F
Credentials:MS TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-3003
Mailing Address - Country:US
Mailing Address - Phone:914-761-2731
Mailing Address - Fax:914-761-1953
Practice Address - Street 1:456 NORTH ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-3003
Practice Address - Country:US
Practice Address - Phone:914-761-2731
Practice Address - Fax:914-761-1953
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1176881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist