Individual
CHARITY INCOGNITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9015 SUTTER AVE, OZONE PARK, NY 11417-1431
(718) 845-7560
Mailing address
9015 SUTTER AVE, OZONE PARK, NY 11417-1431
(718) 845-7560
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016833
NY
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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