Healthcare Provider Details

I. General information

NPI: 1235052226
Provider Name (Legal Business Name): JESSIKA JEAN KAHNLE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S CANAAN RD
CANAAN CT
06018-2502
US

IV. Provider business mailing address

69 N ALANDALE AVE
SCHENECTADY NY
12304-4202
US

V. Phone/Fax

Practice location:
  • Phone: 860-824-5137
  • Fax:
Mailing address:
  • Phone: 518-669-6689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number035412
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18.008699
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: