Provider Demographics
NPI:1366680480
Name:AVILES, DORINDA (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DORINDA
Middle Name:
Last Name:AVILES
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 1:75 WINDERMERE DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2415
Mailing Address - Country:US
Mailing Address - Phone:914-450-6272
Mailing Address - Fax:
Practice Address - Street 1:75 WINDERMERE DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2415
Practice Address - Country:US
Practice Address - Phone:914-450-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013957-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist