Individual
ANGELICA RE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 16TH AVE, BROOKLYN, NY 11204-1002
(718) 438-0155
Mailing address
4200 16TH AVE, BROOKLYN, NY 11204-1002
(718) 438-0155
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
022191
NY
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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