Individual
LARISSA CANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 HILLSIDE AVE, NUTLEY, NJ 07110-1615
(201) 787-6669
Mailing address
45 HILLSIDE AVE, NUTLEY, NJ 07110-1615
(201) 787-6669
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00525200
NJ
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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