Provider Demographics
NPI:1396351342
Name:NOBRIGA, KARA SHEA (CCC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:SHEA
Last Name:NOBRIGA
Suffix:
Gender:F
Credentials:CCC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:SHEA
Other - Last Name:BRAVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1337
Mailing Address - Country:US
Mailing Address - Phone:718-619-5799
Mailing Address - Fax:
Practice Address - Street 1:221 BROADWAY
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1337
Practice Address - Country:US
Practice Address - Phone:718-442-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030112235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist