Provider Demographics
NPI:1033633854
Name:WEBB, AYANA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:WEBB
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 1:33 HILLSIDE AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2157
Mailing Address - Country:US
Mailing Address - Phone:732-675-0279
Mailing Address - Fax:
Practice Address - Street 1:33 HILLSIDE AVE APT 7
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2157
Practice Address - Country:US
Practice Address - Phone:732-675-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00442200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty