# VIVIAN LIFF SPEECH THERAPY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467691782
- **Authorized official:** MAUREEN KELLERMAN SPEECH LANGUAGE PATH (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (845) 583-4283

## Contact information

- **Practice address:** 90 HORSEHOE LAKE ROAD, KAUNEGONA LAKE, NY 12749
- **Practice address phone:** (845) 583-4283
- **Practice address fax:** (845) 583-5476
- **Mailing address:** PO BOX 600, KAUNEONGA LAKE, NY 12749-0600
- **Mailing address phone:** (845) 583-4283
- **Mailing address fax:** (845) 583-5476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 0087791 | NY | Yes |

## Other

- **Enumeration date:** 02/10/2009
- **Last updated:** 02/10/2009