Individual provider · Type 1 NPI

Kimberly Pettis, M.S.CCC-SLP

Speech-Language Pathologist · Port Jefferson, NY

NPI number 1689739914 Active

Practice location

200 Belle Terre Rd
Port Jefferson, NY 11777-1928

Call (631) 474-6263 Map

Mailing address

7 Robin Dr
Hauppauge, NY 11788-1104

Specialties and licenses

TaxonomyCodeLicense
Speech-Language Pathologist Primary 235Z00000X012235-1 (NY)

Speech-Language Pathologist: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonan…

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About NPI 1689739914

Kimberly Pettis, M.S.CCC-SLP's National Provider Identifier is 1689739914, issued on Dec 27, 2006. The primary taxonomy on file is Speech-Language Pathologist (235Z00000X), and the practice location is in Port Jefferson, NY. The record was last updated on Jul 8, 2007.