Doctor Name: | INGRID RENEE DESORMES |
NPI Number: | 1134459043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CF-SLP |
License Number: | SZ4711 |
Business Practice Address: | 900 N Federal Hwy Ste 220 Boca Raton, FL - 334322753 |
Business Phone Number: | 5619946590 |
Business Fax Number: | |
Mailing Address: | 15000 Portofino Cir Apt 125, PALM BEACH GARDENS |
State: | FL |
Postal Code: | 334181250 |
Phone Number: | 5615413934 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2009 |
NPI Last Update Date: | 12/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ4711 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |