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Organization
LEGENDARY SPEECH PATHOLOGY PLLC
Active
Organization
LEGENDARY SPEECH PATHOLOGY PLLC
Active
Other names
Legendary Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHEL WEISS (DIRECTOR)
(917) 744-3976
Entity
Organization
Contact information
Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Mailing address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
011183
NY
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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