Provider Demographics
NPI:1326288879
Name:GUTTMAN-EHRLICH, REBECCA RAIZY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RAIZY
Last Name:GUTTMAN-EHRLICH
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 1:655 IBSEN ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2717
Mailing Address - Country:US
Mailing Address - Phone:516-295-2045
Mailing Address - Fax:
Practice Address - Street 1:655 IBSEN ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2717
Practice Address - Country:US
Practice Address - Phone:516-295-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY914991-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist