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General NPI Number Information
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NPI Number | 1104426600
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Entity Type | Individual
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Provider Name | YAEL SELEVAN-GRANICK SLP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | YONA BEN AMITAI 2/6
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City | BET SHEMESH
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State | ISRAEL
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Zip | 9931408
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Country | IL
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Telephone | 718-702-1754
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Fax |
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Provider Business Mailing Address
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Address Line | 5 E STEMMER LN
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City | SUFFERN
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State | NY
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Zip | 10901-4304
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Country | US
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Telephone | 718-702-1754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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