Individual
BO YEON IHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS., CCC-SLP
Contact information
Practice address
5601 16TH AVE, BROOKLYN, NY 11204-1809
(718) 851-8070
Mailing address
5601 16TH AVE, BROOKLYN, NY 11204-1809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
029056
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029056
NEW YORK STATE LICENSE
NY
Enumeration date
09/06/2019
Last updated
09/06/2019
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