Provider Demographics
NPI:1104426600
Name:SELEVAN-GRANICK, YAEL (SLP)
Entity type:Individual
Prefix:MRS
First Name:YAEL
Middle Name:
Last Name:SELEVAN-GRANICK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E STEMMER LN
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4304
Mailing Address - Country:US
Mailing Address - Phone:718-702-1754
Mailing Address - Fax:
Practice Address - Street 1:YONA BEN AMITAI 2/6
Practice Address - Street 2:
Practice Address - City:BET SHEMESH
Practice Address - State:ISRAEL
Practice Address - Zip Code:9931408
Practice Address - Country:IL
Practice Address - Phone:718-702-1754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist