Healthcare Provider Details

I. General information

NPI: 1407792393
Provider Name (Legal Business Name): CHLOE JOY PEARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CRAIG AVE
FREEPORT NY
11520-1516
US

IV. Provider business mailing address

103 CRAIG AVE
FREEPORT NY
11520-1516
US

V. Phone/Fax

Practice location:
  • Phone: 267-567-5763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: