Individual
ALEXIS BOLIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2 IRVING ST, EAST ORANGE, NJ 07018-1914
(201) 647-9319
(973) 766-1704
Mailing address
2 IRVING ST, EAST ORANGE, NJ 07018-1914
(201) 647-9319
(973) 766-1704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00576500
NJ
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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