Doctor Name: | AMY DETERS |
NPI Number: | 1104027416 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 01612 |
Business Practice Address: | 2625 Iowa St Perry, IA - 502202413 |
Business Phone Number: | 6158966400 |
Business Fax Number: | |
Mailing Address: | 225 Prairie View Dr, 5312 WEST DES MOINES |
State: | IA |
Postal Code: | 502667114 |
Phone Number: | 5152500198 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 01612 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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 |