Doctor Name: | MRS. DIANA MARIA YAKUBOV |
NPI Number: | 1982925293 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC M.S. SLP |
License Number: | 020105 |
Business Practice Address: | 18508 Union Tpke Ste. 101 Fresh Meadows, NY - 113661700 |
Business Phone Number: | 7182647250 |
Business Fax Number: | |
Mailing Address: | 14429 76th Ave, FLUSHING |
State: | NY |
Postal Code: | 113673115 |
Phone Number: | 7185445171 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2010 |
NPI Last Update Date: | 06/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 020105 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |