Individual
MRS. DEENA MICHELLE BODENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SLP
Contact information
Practice address
1509 NEWPORT DR, LAKEWOOD, NJ 08701-3918
(732) 905-8212
Mailing address
1509 NEWPORT DRIVE, LAKEWOOD, NJ 08701
(732) 905-8212
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00527500
NJ
Other
Enumeration date
10/18/2010
Last updated
08/11/2011
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