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Organization
NEW YORK SPEECH AND LANGUAGE PLLC
Active
Organization
NEW YORK SPEECH AND LANGUAGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN WILLS M.S. CCC-SLP (PARTNER, SLP)
(302) 841-7685
Entity
Organization
Contact information
Practice address
4505 BROADWAY, ASTORIA, NY 11103-1625
(302) 841-7685
Mailing address
4505 BROADWAY, ASTORIA, NY 11103-1625
(302) 841-7685
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05081663
—
NY
Enumeration date
01/22/2019
Last updated
01/22/2019
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