Individual
KELLEY SCHUPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5-11 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5635
(201) 509-8205
Mailing address
914 GRANDVIEW AVE, WESTFIELD, NJ 07090-1629
(908) 577-1190
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00853700
NJ
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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