Provider Demographics
NPI:1841449816
Name:SPEARMAN, DINA (MACCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:SPEARMAN
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13623 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2327
Mailing Address - Country:US
Mailing Address - Phone:718-268-8897
Mailing Address - Fax:718-268-8897
Practice Address - Street 1:13623 72ND AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2327
Practice Address - Country:US
Practice Address - Phone:718-268-8897
Practice Address - Fax:718-268-8897
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist