Basic Information
| Provider Information | |||||||||
| NPI: | 1083227326 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAGRECA | ||||||||
| FirstName: | SABRINA | ||||||||
| MiddleName: | DENAE | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 427 OCEANPOINT AVE | ||||||||
| Address2: | |||||||||
| City: | CEDARHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115161326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165123596 | ||||||||
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| Practice Location | |||||||||
| Address1: | 50-05 31ST AVE | ||||||||
| Address2: | |||||||||
| City: | QUEENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113771400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187282676 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2020 | ||||||||
| LastUpdateDate: | 10/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.