Doctor Name: | MISS KYM ERIN MARTIN |
NPI Number: | 1104964832 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | SLP4166 |
Business Practice Address: | 15526 N 164th Ln Surprise, AZ - 853881107 |
Business Phone Number: | 6232298574 |
Business Fax Number: | |
Mailing Address: | 215 W Portland St Unit 246c, PHOENIX |
State: | AZ |
Postal Code: | 850035429 |
Phone Number: | 6232298574 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 03/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP4166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |