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General NPI Number Information
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NPI Number | 1588688097
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Entity Type | Organization
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Legal Business Name | QUEENS COLLEGE SPEECH LANGUAGE HEARING CENTER
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6530 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11367-1575
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Country | US
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Telephone | 718-997-2930
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Fax | 718-997-2935
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Provider Business Mailing Address
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Address Line | 6530 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11367-1575
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Country | US
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Telephone | 718-997-2930
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Fax | 718-997-2935
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Authorized Official
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Title or Position | DIRECTOR
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Name | PROF. ARLENE KRAAT
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Credential | M.A.
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Telephone | 718-997-2940
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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 | 000693-1
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License Number State | NY
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