Individual
ANASTASIA IVANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP, TSSLD
Contact information
Practice address
3368 SHORE PKWY APT B4, BROOKLYN, NY 11235-2713
(646) 410-6879
Mailing address
3368 SHORE PKWY APT B4, BROOKLYN, NY 11235-2713
(646) 410-6879
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
028568
NY
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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