Provider Demographics
NPI:1073870796
Name:DESAI-WEIMER, VIBHA (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:VIBHA
Middle Name:
Last Name:DESAI-WEIMER
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:VIBHA
Other - Middle Name:
Other - Last Name:DESAI-WEIMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC/SLP
Mailing Address - Street 1:107 WHITLOCK CT
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-7937
Mailing Address - Country:US
Mailing Address - Phone:732-598-1736
Mailing Address - Fax:
Practice Address - Street 1:107 WHITLOCK CT
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-7937
Practice Address - Country:US
Practice Address - Phone:732-598-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00273700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist