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Individual

KISAIRA HENRIQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
56 HAMILTON AVE, PASSAIC, NJ 07055-5131
(973) 773-7070
Mailing address
19 GLEN ST, CLIFFSIDE PARK, NJ 07010-2003
(201) 220-5022

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
NJ

Other

Enumeration date
06/08/2017
Last updated
07/21/2022
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