Provider Demographics
NPI:1649571357
Name:STYLMAN, RANDI (SLP)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:
Last Name:STYLMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1436
Mailing Address - Country:US
Mailing Address - Phone:973-535-1931
Mailing Address - Fax:
Practice Address - Street 1:66 W MOUNT PLEASANT AVE
Practice Address - Street 2:203
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2900
Practice Address - Country:US
Practice Address - Phone:973-994-4468
Practice Address - Fax:973-994-4412
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00189200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist