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Individual

MRS. TAL HASBANI WOODBURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
100 CUMMINGS CTR STE 350G, BEVERLY, MA 01915-6136
(978) 712-0003
(866) 258-7586
Mailing address
1133 SE 37TH AVE, PORTLAND, OR 97214-4309
(503) 381-4058

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12079
OR
235Z00000X
Speech-Language Pathologist
Primary
77792-SP-SL
MA
235Z00000X
Speech-Language Pathologist
LL 60485479
WA

Other

Enumeration date
09/24/2014
Last updated
08/11/2021
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