Provider Demographics
NPI:1497052252
Name:HERSZKOPF OREAMUNO, YAEL (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YAEL
Middle Name:
Last Name:HERSZKOPF OREAMUNO
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 1:17670 NW 78TH AVE
Mailing Address - Street 2:STE 113
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3665
Mailing Address - Country:US
Mailing Address - Phone:305-512-5757
Mailing Address - Fax:305-512-5755
Practice Address - Street 1:17670 NW 78TH AVE
Practice Address - Street 2:STE 113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33015-3665
Practice Address - Country:US
Practice Address - Phone:305-512-5757
Practice Address - Fax:305-512-5755
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2151235Z00000X
FLSA 11566235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist