| Doctor Name: | MARTHA H VAN DAM |
| NPI Number: | 1164731998 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 4102 |
| Business Practice Address: | 706 Pelzer Hwy Easley, SC - 296422941 |
| Business Phone Number: | 8648590167 |
| Business Fax Number: | 8648592312 |
| Mailing Address: | 2222 Sullivan Trl, EASTON |
| State: | PA |
| Postal Code: | 180407958 |
| Phone Number: | 8009449782 |
| Fax Number: | 6104382046 |
| NPI Enumeration Date: | 09/28/2010 |
| NPI Last Update Date: | 09/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| 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 |