| NPI | 1568602563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN BEVILACQUA Speech Language Pathologist 718-208-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: NY 0164531) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 0164531) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2009-03-03 |