Individual
MS. BRENDA WALDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1671 WALNUT AVE, MERRICK, NY 11566-2220
(917) 515-1888
Mailing address
1671 WALNUT AVE, MERRICK, NY 11566-2220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
N/A
—
Enumeration date
11/20/2013
Last updated
06/26/2022
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