Provider Demographics
NPI:1124257522
Name:WEISBROT, DANA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:WEISBROT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CITY PL
Mailing Address - Street 2:APARTMENT 25D
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3338
Mailing Address - Country:US
Mailing Address - Phone:516-662-1985
Mailing Address - Fax:
Practice Address - Street 1:10 CITY PL
Practice Address - Street 2:APARTMENT 25D
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3338
Practice Address - Country:US
Practice Address - Phone:516-662-1985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist