Individual
AMY LILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 WALBROOKE AVE, STATEN ISLAND, NY 10301-2654
(718) 815-7603
Mailing address
117 WALBROOKE AVE, STATEN ISLAND, NY 10301-2654
(718) 273-6161
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
019782
NY
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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