Organization
MASHA SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIYA YUNUSOVA MA SLP CCC (PRESIDENT)
(917) 923-7910
Entity
Organization
Contact information
Practice address
9609 67TH AVE APT 3J, REGO PARK, NY 11374-5102
(917) 923-7910
Mailing address
9609 67TH AVE APT 3J, REGO PARK, NY 11374-5102
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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