Provider Demographics
NPI:1649585811
Name:HABER, YONINA BETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:YONINA
Middle Name:BETH
Last Name:HABER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4707
Mailing Address - Country:US
Mailing Address - Phone:201-408-5122
Mailing Address - Fax:
Practice Address - Street 1:401 GLOUCESTER ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4707
Practice Address - Country:US
Practice Address - Phone:201-408-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012839235Z00000X
NJ41YS0056900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist