Provider Demographics
NPI:1457774655
Name:STEIN, CARA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:STEIN
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 1:313 E RIDGEWOOD AVE
Mailing Address - Street 2:1D
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3328
Mailing Address - Country:US
Mailing Address - Phone:201-841-7903
Mailing Address - Fax:
Practice Address - Street 1:313 E RIDGEWOOD AVE
Practice Address - Street 2:1D
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3328
Practice Address - Country:US
Practice Address - Phone:201-841-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00607800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist