Individual
CHAYA WYDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
809 RIVER AVE STE 4, LAKEWOOD, NJ 08701-5286
(732) 534-6707
(732) 730-5968
Mailing address
36 HIGH ST, LAKEWOOD, NJ 08701-5223
(732) 804-6011
(732) 730-5968
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00683500
NJ
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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