Individual
MRS. ETTY SARA DAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
400 TWIN OAKS DR, LAKEWOOD, NJ 08701-7146
(732) 363-3699
Mailing address
400 TWIN OAKS DR, LAKEWOOD, NJ 08701-7146
(732) 363-3699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
013276-1
NY
235Z00000X
Speech-Language Pathologist
Primary
41YS00477900
NJ
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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