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1225587017
LAURELAI HISTED
BRONX, NY
NPI
1225587017
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NY 026118-1)
Enumeration Date
2016-09-22
Last Update Date
2016-09-22
Business Address
-- LAURELAI HISTED M.S., CCC-SLP
1000 HUTCHINSON RIVER PKWY
BRONX, NY 10465-1820
Phone number: 630-632-2054
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Mailing Address
-- LAURELAI HISTED M.S., CCC-SLP
3246 FAIRMOUNT AVE
BRONX, NY 10465-1446
Phone number:
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