Provider Demographics
NPI:1700329471
Name:DELSIE, CHARITY (MS CCC-SLP TSSLD)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:DELSIE
Suffix:
Gender:F
Credentials:MS CCC-SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 3RD AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2302
Mailing Address - Country:US
Mailing Address - Phone:413-205-6087
Mailing Address - Fax:
Practice Address - Street 1:2121 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3702
Practice Address - Country:US
Practice Address - Phone:413-205-6087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist