Provider Demographics
NPI:1013207638
Name:DREIFUS, VICKY (MS,CCC - SLP)
Entity Type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:
Last Name:DREIFUS
Suffix:
Gender:F
Credentials:MS,CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 AVENUE P
Mailing Address - Street 2:APT D6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1448
Mailing Address - Country:US
Mailing Address - Phone:718-998-3986
Mailing Address - Fax:
Practice Address - Street 1:2001 AVENUE P
Practice Address - Street 2:APT D6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1448
Practice Address - Country:US
Practice Address - Phone:718-998-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004140-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist