Organization Name: | SEAGULL VENTURES LLC |
NPI Number: | 1114289352 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALISON WALDMANN (OWNER/SLP) |
Mailing Address: | 19 Meadow Ridge Ln New Milford |
State: | CT US |
Postal Code: | 067763740 |
Phone Number: | 2039475782 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2012 |
NPI Last Update Date: | 08/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 003097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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 |