Doctor Name: | MRS. MEGARA FITZGIBBONS BOLLER |
NPI Number: | 1013161983 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | 018G12-1 |
Business Practice Address: | 1000 Elmwood Ave Suite 400 Rochester, NY - 14620 |
Business Phone Number: | 5852710680 |
Business Fax Number: | 5852716977 |
Mailing Address: | 1000 Elmwood Ave, Suite 400 ROCHESTER |
State: | NY |
Postal Code: | 14620 |
Phone Number: | 5852710680 |
Fax Number: | 5852716977 |
NPI Enumeration Date: | 11/05/2008 |
NPI Last Update Date: | 11/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 018G12-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |