Provider Demographics
NPI:1336510270
Name:REICH, VIVIAN (SPEECH THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:
Last Name:REICH
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 COUNTY ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670
Mailing Address - Country:US
Mailing Address - Phone:201-894-5800
Mailing Address - Fax:201-894-5990
Practice Address - Street 1:120 COUNTY ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670
Practice Address - Country:US
Practice Address - Phone:201-894-5800
Practice Address - Fax:201-894-5990
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00818500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist