Provider Demographics
NPI:1700588225
Name:ABRAHAM, DAPHNE CELESTE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:CELESTE
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2412
Mailing Address - Country:US
Mailing Address - Phone:908-477-7758
Mailing Address - Fax:
Practice Address - Street 1:414 N MIDLAND AVE APT B2
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5727
Practice Address - Country:US
Practice Address - Phone:908-477-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01110700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist