Doctor Name: | MR. RICHARD B DEWITT |
NPI Number: | 1114187259 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SPEECH LANGUAGE PATH |
License Number: | 10495 |
Business Practice Address: | 781 Black Oak Dr Suite 101 Medford, OR - 975049502 |
Business Phone Number: | 5417894255 |
Business Fax Number: | 5417895820 |
Mailing Address: | 781 Black Oak Drive, Suite 101 MEDFORD |
State: | OR |
Postal Code: | 97504 |
Phone Number: | 5417894255 |
Fax Number: | 5417895820 |
NPI Enumeration Date: | 06/12/2008 |
NPI Last Update Date: | 06/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 10495 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
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 |