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Organization
EDWARD D. MYSAK CLINIC FOR COMMUNICATION DISORDERS
Active
Organization
EDWARD D. MYSAK CLINIC FOR COMMUNICATION DISORDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN MARIE YOUSE PH.D. CCC-SLP (DIRECTOR)
(212) 678-3410
Entity
Organization
Contact information
Practice address
525 W 120TH ST, BOX 191, NEW YORK, NY 10027-6605
(212) 678-3409
Mailing address
525 W 120TH ST, BOX 191, NEW YORK, NY 10027-6605
(212) 678-3409
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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