Provider Demographics
NPI:1184851339
Name:WOLLMAN, IRIT (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:IRIT
Middle Name:
Last Name:WOLLMAN
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 1:105 SIMI CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3752
Mailing Address - Country:US
Mailing Address - Phone:856-304-4797
Mailing Address - Fax:
Practice Address - Street 1:105 SIMI CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3752
Practice Address - Country:US
Practice Address - Phone:856-304-4797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009273235Z00000X
NJ41YS00548500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist