Provider Demographics
NPI:1174834436
Name:CAMEJO, MARIELA BERENICE (MA, SLP-TSLD)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:BERENICE
Last Name:CAMEJO
Suffix:
Gender:F
Credentials:MA, SLP-TSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13909 84TH DR
Mailing Address - Street 2:605
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1800
Mailing Address - Country:US
Mailing Address - Phone:718-607-6799
Mailing Address - Fax:718-785-0420
Practice Address - Street 1:13909 84TH DR
Practice Address - Street 2:605
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-1800
Practice Address - Country:US
Practice Address - Phone:718-607-6799
Practice Address - Fax:718-785-0420
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015898-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist