Mindy Beth Bodzin, MA,CCCSLP
Individual provider Active NPI Speech-Language Pathologist · Freeport, NY
NPI 1700917465 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700917465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 011663-1 (NY)
- Practice address
- 116 Westend Ave
Unit 39
Freeport, NY 11520-5251 - Phone
- (516) 378-5297
- Fax
- (516) 378-5297
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011663-1 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 011663-1 | NY | Yes |
Addresses
Primary practice location
116 Westend Ave
Unit 39
Freeport, NY 11520-5251
Mailing address
116 Westend Ave
Unit 39
Freeport, NY 11520-5251
Phone (516) 378-5297
Other providers in Freeport, NY
- Ellen Sue Blume
- Renee Denise Bodley
- Body Power Physical Therapy PC
- Body Power Physical Therapy, P C
- Body Power Physical Therapy,P.C.
- Soraya Marie Bonny-Rankin
- Yolande Bostic
- Braces World LLC
- Genell Lorencia Bradley
- Gennel Tanisha Bradley
All providers in Freeport, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.