Doctor Name: | IVELISSE PINERO |
NPI Number: | 1205065075 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS,SLP,CCPLSVT,BOM |
License Number: | 908 |
Business Practice Address: | Baralt Calle Marginal A-49 Fajardo, PR - 00738 |
Business Phone Number: | 7876922422 |
Business Fax Number: | |
Mailing Address: | Urb. Casa Bella, 35 Calle Napoles NAGUABO |
State: | PR |
Postal Code: | 007182826 |
Phone Number: | 7876922422 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 08/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 908 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
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 |