Provider Demographics
NPI:1053608422
Name:BOODOOSINGH, BACHANNE
Entity type:Individual
Prefix:
First Name:BACHANNE
Middle Name:
Last Name:BOODOOSINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 12052
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BO. SUSUA BAJA
Practice Address - Street 2:SECTOR GEMINIS CALLE LOS CASIANOS
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-0098
Practice Address - Country:US
Practice Address - Phone:787-856-3347
Practice Address - Fax:787-992-8343
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11552355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant