Organization
YO PHILLY KIDS LLC
Active
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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