Healthcare Provider Details

I. General information

NPI: 1730335639
Provider Name (Legal Business Name): TARYN KAYE PUTNEY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARYN KAYE PUTNEY M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 STRATTON LN
STILLWATER NY
12170-1502
US

IV. Provider business mailing address

50 STRATTON LN
STILLWATER NY
12170-1502
US

V. Phone/Fax

Practice location:
  • Phone: 518-598-7332
  • Fax:
Mailing address:
  • Phone: 518-598-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number017322
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: