Provider Demographics
NPI:1699106815
Name:TONYA'S SPEECH WONDERS SLP, PC
Entity type:Organization
Organization Name:TONYA'S SPEECH WONDERS SLP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTONINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOROBEYCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:347-622-3493
Mailing Address - Street 1:460 NEPTUNE AVE
Mailing Address - Street 2:APT 12D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4319
Mailing Address - Country:US
Mailing Address - Phone:718-975-0375
Mailing Address - Fax:
Practice Address - Street 1:460 NEPTUNE AVE
Practice Address - Street 2:APT 12D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4301
Practice Address - Country:US
Practice Address - Phone:718-975-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020763-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty