Individual
CATHY JEAN EKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
352 MARTHA AVE, BELLPORT, NY 11713
(631) 276-6703
Mailing address
11 VIOLET RD, ROCKY POINT, NY 11778-8736
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003668-1
NY
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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