Provider Demographics
NPI:1740169036
Name:REYES, YANIZ MARIE (MS CCC-SLP TSSLD)
Entity type:Individual
Prefix:
First Name:YANIZ
Middle Name:MARIE
Last Name:REYES
Suffix:
Gender:F
Credentials:MS CCC-SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 80TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4010
Mailing Address - Country:US
Mailing Address - Phone:347-768-5531
Mailing Address - Fax:
Practice Address - Street 1:350 67TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5301
Practice Address - Country:US
Practice Address - Phone:718-759-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14337691235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist