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Organization

YO PHILLY KIDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACLYN G POLAKOFF M.S. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(856) 495-6581
Entity
Organization

Contact information

Practice address
708 S BANCROFT ST, PHILADELPHIA, PA 19146-2019
(856) 495-6581
Mailing address
708 S BANCROFT ST, PHILADELPHIA, PA 19146-2019
(856) 495-6581

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT018012
PA
235Z00000X
Speech-Language Pathologist
SL011551
PA

Other

Enumeration date
10/18/2017
Last updated
10/18/2017
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