Individual
MIRIL CARMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 COLES WAY, LAKEWOOD, NJ 08701-4875
(732) 874-4374
(732) 901-8899
Mailing address
108 COLES WAY, LAKEWOOD, NJ 08701-4885
(646) 641-9063
(732) 901-8899
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00619400
NJ
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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