Individual
MRS. IVRIELLE M DWORKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
13-11 ELLIS AVE, FAIR LAWN, NJ 07410-6201
(646) 241-6766
Mailing address
13-11 ELLIS AVE, FAIR LAWN, NJ 07410-6201
(646) 241-6766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00744300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12154630
AMERICAN SPEECH/LANGUAGE HEARING ASSOCIATION (ASHA)
—
Enumeration date
08/16/2023
Last updated
08/16/2023
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