Provider Demographics
NPI:1356765499
Name:PARBHOO, POONAM HARSHAD
Entity type:Individual
Prefix:MRS
First Name:POONAM
Middle Name:HARSHAD
Last Name:PARBHOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 E ANAHEIM ST
Mailing Address - Street 2:APT 202
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3300
Mailing Address - Country:US
Mailing Address - Phone:562-881-2883
Mailing Address - Fax:
Practice Address - Street 1:1979 LAKESIDE PKWY
Practice Address - Street 2:SUITE 800
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5935
Practice Address - Country:US
Practice Address - Phone:770-325-0556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist