Doctor Name: | MARK ANTHONY TADDEO |
NPI Number: | 1053705251 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., CF-SLP |
License Number: | SP-1778 |
Business Practice Address: | 10318 Canvas Canyon Ct Las Vegas, NV - 891786541 |
Business Phone Number: | 7022772523 |
Business Fax Number: | |
Mailing Address: | 10318 Canvas Canyon Ct, LAS VEGAS |
State: | NV |
Postal Code: | 891786541 |
Phone Number: | 7022772523 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP-1778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
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 |