Organization
AWOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY WOLLER MA, CCC-SLP, TSSLD (SPEECH LANGUAGE PATHOLOGIST)
(732) 609-7671
Entity
Organization
Contact information
Practice address
25 DICKINSON RD, KENDALL PARK, NJ 08824-1844
(732) 609-7671
Mailing address
25 DICKINSON RD, KENDALL PARK, NJ 08824-1844
(732) 609-7671
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
10/02/2024
Last updated
10/22/2024
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