Individual
SHIRA ROTTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
207 1ST ST APT 403, LAKEWOOD, NJ 08701-3368
(718) 951-8800
(718) 951-0846
Mailing address
207 1ST ST APT 403, LAKEWOOD, NJ 08701-3368
(718) 951-8800
(718) 951-0846
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL-2208
LICENSE
NJ
Enumeration date
12/31/2012
Last updated
12/31/2012
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