Doctor Name: | MISS VICTORIA DIANE WANK |
NPI Number: | 1003029331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 04111 |
Business Practice Address: | 6501 N Charles St Towson, MD - 212046819 |
Business Phone Number: | 4109384411 |
Business Fax Number: | |
Mailing Address: | 7936 Belridge Rd, Apt. K BALTIMORE |
State: | MD |
Postal Code: | 212363620 |
Phone Number: | 4438462001 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 02/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 04111 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |