Individual
MRS. ABBY ROCHELLE BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
205 E 1ST ST, CORNING, NY 14830-2809
(607) 654-2433
Mailing address
2860 IRELANDVILLE RD, WATKINS GLEN, NY 14891-9749
(573) 259-4747
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
02206-1
NY
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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