| NPI | 1073781662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE BEVELDUNCAN Speech Pathologist 718-727-6219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 003051-1) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 003051-1) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-21 |