Doctor Name: | HAZEL IVETTE PERDOMO |
NPI Number: | 1134416670 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS-CCC-SLP |
License Number: | 18772 |
Business Practice Address: | 3166 E Palmdale Blvd Ste 112 Palmdale, CA - 935505038 |
Business Phone Number: | 6612748454 |
Business Fax Number: | 6612747614 |
Mailing Address: | 3166 E Palmdale Blvd Ste 112, PALMDALE |
State: | CA |
Postal Code: | 935505038 |
Phone Number: | 6612748454 |
Fax Number: | 6612747614 |
NPI Enumeration Date: | 07/05/2011 |
NPI Last Update Date: | 07/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 18772 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |