Individual ProviderRaina Desiree ThorsenSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address28 Merriman Ave, Staten Island, NY 10314-2431(917) 538-7347PECOS EnrollmentBased on the most recent information from CMS, provider Raina Desiree Thorsen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1538602115Provider TypeIndividualFull NameThorsen, Raina DesireeCredentialM.A., CCC-SLPGenderFemaleSole ProprietorYesEnumeration Date11/30/2016Last Updated6/12/2023Contact InformationPractice LocationPractice Address28 Merriman Ave, Staten Island, NY 10314-2431Phone(917) 538-7347FaxUnlisted FaxMailing LocationMailing Address28 Merriman Ave, Staten Island, NY 10314-2431Phone(917) 538-7347FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense58 017269New York