Individual
BONNIE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 RIDGE HAVEN DR, RIDGE, NY 11961-2127
(631) 278-9348
Mailing address
7 RIDGE HAVEN DR, RIDGE, NY 11961-2127
(631) 278-9348
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
034688
NY
Other
Enumeration date
08/21/2023
Last updated
09/15/2024
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