Organization
LEGENDARY SPEECH PATHOLOGY PLLC
Active
Other names
Legendary Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RACHEL WEISS (DIRECTOR)
(917) 744-3976
Entity
Organization
Contact information
Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Mailing address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(718) 948-1900
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
011183
NY
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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