Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacklyn Nicole Buddenhagen, MA, CF-SLP

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1174087456

Jacklyn Nicole Buddenhagen, MA, CF-SLP is a Student in an Organized Health Care Education/Training Program in Bay Shore, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2019
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

217 5th Ave
Bay Shore, NY 11706-6402
Phone: (631) 968-1140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Craig B Gariepy Ave, Islip Terrace, NY 11752-2820 — (631) 650-6545

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 029245 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NY)

Record details

NPI number1174087456
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , CF-SLP
Sole proprietorNo
NPI enumeratedJanuary 30, 2019
Last updated in NPPESApril 23, 2020
Certification dateApril 23, 2020

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