Doctor Name: | MRS. KATHLYN FORTUNE |
NPI Number: | 1154759686 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 16819 |
Business Practice Address: | 6076 Bristol Pkwy Ste 105 Culver City, CA - 902306600 |
Business Phone Number: | 3106427700 |
Business Fax Number: | |
Mailing Address: | 5815 Doverwood Dr, CULVER CITY |
State: | CA |
Postal Code: | 902307242 |
Phone Number: | 8184397217 |
Fax Number: | |
NPI Enumeration Date: | 10/18/2013 |
NPI Last Update Date: | 10/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 16819 |
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 |