Individual
ANISE ANTOINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
107 E CARPENTER ST, VALLEY STREAM, NY 11580-4419
(917) 873-8776
Mailing address
107 EAST CARPENTER ST., VALLEY STREAM, NY 11580
(917) 873-8776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
223494
NY
235Z00000X
Speech-Language Pathologist
030088-01
—
235Z00000X
Speech-Language Pathologist
Primary
223494
NY
Other
Enumeration date
06/14/2012
Last updated
09/21/2020
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