Provider Demographics
NPI:1073749362
Name:BOBKER, HADASSA NICOLE (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:HADASSA
Middle Name:NICOLE
Last Name:BOBKER
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 1:2 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1317
Mailing Address - Country:US
Mailing Address - Phone:516-371-9592
Mailing Address - Fax:
Practice Address - Street 1:2 HOLLY LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1317
Practice Address - Country:US
Practice Address - Phone:516-371-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist