Doctor Name: | JEFFREY ADAM VONREKOWSKI |
NPI Number: | 1033461025 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, CCC-SLP |
License Number: | 260 |
Business Practice Address: | 3691 Ben Walters Ln Ste 4 Homer, AK - 996037750 |
Business Phone Number: | 9072356044 |
Business Fax Number: | |
Mailing Address: | 1585 Mission Rd, HOMER |
State: | AK |
Postal Code: | 996039361 |
Phone Number: | 9073063225 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2012 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 260 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
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 |