Provider Demographics
NPI:1578848479
Name:KLEIN, SHEILA (CCC-A)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 DARTMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1012
Mailing Address - Country:US
Mailing Address - Phone:516-374-2733
Mailing Address - Fax:
Practice Address - Street 1:1040 DARTMOUTH LN
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1012
Practice Address - Country:US
Practice Address - Phone:516-374-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000617231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist