Provider Demographics
NPI:1922829878
Name:SIROWICH, KIERSTEN E
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:E
Last Name:SIROWICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 HARTFORD TPKE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06247-1320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:354 HARTFORD TPKE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06247-1320
Practice Address - Country:US
Practice Address - Phone:860-455-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech