Individual
MS. ANTHEA VIVONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.PHIL, CCC-SLP
Contact information
Practice address
10-24 49 AVENUE, BIRCH FAMILY SERVICES, LONG ISLAND CITY, NY 11101
(718) 786-1104
(718) 391-0040
Mailing address
10-24 49 AVENUE, BIRCH FAMILY SERVICES, LONG ISLAND CITY, NY 11101
(718) 786-1104
(718) 391-0040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
009055-1
NY
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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