Provider Demographics
NPI:1013684539
Name:PASAHOL, MARIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PASAHOL
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 1:188 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1802
Mailing Address - Country:US
Mailing Address - Phone:551-697-4738
Mailing Address - Fax:
Practice Address - Street 1:35 JOURNAL SQUARE PLZ
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3871
Practice Address - Country:US
Practice Address - Phone:551-247-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01081400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist