Individual
AHUVA GOLDBURD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
95 CANARY DR, LAKEWOOD, NJ 08701-5453
(917) 903-0667
Mailing address
95 CANARY DR, LAKEWOOD, NJ 08701-5453
(917) 903-0667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00645200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41YS00645200
NJ STATE LICENSE
NJ
Enumeration date
09/09/2017
Last updated
07/21/2022
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