Provider Demographics
NPI:1730249400
Name:SAMUELS, ADELINA A (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ADELINA
Middle Name:A
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:MA,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:LITTLE STEPS SPEECH AND LANGUGAE CLINIC
Mailing Address - Street 2:193 ROUTE 9 SOUTH SUITE 2D
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-683-1030
Mailing Address - Fax:732-683-0030
Practice Address - Street 1:6370 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2831
Practice Address - Country:US
Practice Address - Phone:929-335-7707
Practice Address - Fax:929-335-7709
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00454600235Z00000X
NY010857-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist