Organization
SOUTH JERSEY SPEECH LANGUAGE PATHOLOGY
Active
Other names
SJSLP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIBEL WILLSON M.S., CCC-SLP (OWNER)
(646) 234-3756
Entity
Organization
Contact information
Practice address
1118 PARK AVE, COLLINGSWOOD, NJ 08108-3317
(646) 234-3756
(856) 210-7488
Mailing address
1118 PARK AVE, COLLINGSWOOD, NJ 08108-3317
(646) 234-3756
(856) 210-7488
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
41YS00849400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114259850
—
NY
Enumeration date
01/17/2018
Last updated
06/16/2018
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