Individual
BRUCE ENGHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
4 YANKEE PL, ELLENVILLE, NY 12428-1510
(845) 647-6464
Mailing address
70 KUKUK LN, KINGSTON, NY 12401-6943
(845) 336-2616
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
008296-1
NY
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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