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Individual

ANASTASIA EVANOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.ED, CCC-SLP

Contact information

Practice address
29-01 216TH STREET, CENTER FOR PEDIATRIC FEEDING DISORDERS, BAYSIDE, NY 11360
(718) 281-8947
Mailing address
29-01 216TH STREET, CENTER FOR PEDIATRIC FEEDING DISORDERS, BAYSIDE, NY 11360

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
028906
NY
235Z00000X
Speech-Language Pathologist
SL014506
PA

Other

Enumeration date
05/22/2020
Last updated
05/22/2020
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