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1821130659
KRISTA BOURNE
PORT JEFFERSON STATION, NY
NPI
1821130659
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: NY 008092-1)
Enumeration Date
2007-02-12
Last Update Date
2007-07-08
Business Address
KRISTA BOURNE
15 LILLIAN STREET
PORT JEFFERSON STATION, NY 11776
Phone number: 631-474-8697
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Mailing Address
KRISTA BOURNE
15 LILLIAN STREET
PORT JEFFERSON STATION, NY 11776
Phone number: 631-474-8697
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