| NPI | 1033615117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA L THYBERG CEO 631-363-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 007450-1) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2018-04-05 |