Provider Demographics
NPI:1265684534
Name:WETHERBEE, ROBERTA JANIS (MA,CCC-SLP, TSHH)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:JANIS
Last Name:WETHERBEE
Suffix:
Gender:F
Credentials:MA,CCC-SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 NORTHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1518
Mailing Address - Country:US
Mailing Address - Phone:914-261-3007
Mailing Address - Fax:914-693-8544
Practice Address - Street 1:71 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1518
Practice Address - Country:US
Practice Address - Phone:914-261-3007
Practice Address - Fax:914-693-8544
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010558-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist