ISLAND THERAPY SPEECH SERVICES
Agencies at Durkee Ln, Canaan Lake, NY

License number
New York 010393
Category
Agencies
Type
Local Education Agency (LEA)
Owner
Name: CAROLINE CATHERINE BRABAZON-WILKINSON MSCCCSLP
Title: OWNER
Phone: (631) 286-0343
Address
Address 2
95 Durkee Ln, Canaan Lake, NY 11772
PO Box 6, North Bellport, NY 11713
National Provider ID: 1346396249
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ISLAND THERAPY SPEECH SERVICES, PC

Canaan Lake, NY  -  North Bellport, NY

Registration:
Nov 12, 2003
Addresses:
95 Durkee Ln, Patchogue, NY 11772 (Physical)
103 Country Clb Rd, Bellport, NY 11713 (Physical)
State ID:
2976307
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Caroline C Brabazon, 103 Country Clb Rd, Bellport, NY 11713 (Physical)
Agent:
Caroline Brabazon-Wilkinson,95 Durkee Ln, Patchogue, NY 11772 (Physical)

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