Individual
CHARLYN BREA-GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-7364
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-7364
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
028307
NY
Other
Enumeration date
01/01/2019
Last updated
12/01/2020
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