Provider First Line Business Practice Location Address:
200 OLD FARMINGDALE RD
Provider Second Line Business Practice Location Address:
WB JR. HIGH SCHOOL - SPEECH THERAPIST
Provider Business Practice Location Address City Name:
WEST BABYLON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11704-6508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-330-9153
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2014