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Organization

CHEMUNG COUNTY EARLY INTERVENTION PROGRAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANNE L JERNIGAN M.S. CCC-SLP (EARLY INTERVENTION OFFICIAL)
(607) 737-5568
Entity
Organization

Contact information

Practice address
425 PENNSYLVANIA AVE, ELMIRA, NY 14904-1762
(607) 737-5569
(607) 737-5480
Mailing address
425 PENNSYLVANIA AVE, ELMIRA, NY 14904-1762
(607) 737-5569
(607) 737-5480

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
252Y00000X
Early Intervention Provider Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01760530
NY
Enumeration date
04/30/2007
Last updated
07/30/2012
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