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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1605 VOORHIES AVE, BROOKLYN, NY 11235-3980
(631) 902-5439
Mailing address
1058 W MAIN ST, RIVERHEAD, NY 11901-2820

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
235Z00000X
Speech-Language Pathologist
Primary
033191-01
NY

Other

Enumeration date
06/21/2022
Last updated
05/20/2024
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