Doctor Name: | MRS. PATRICIA MARTIN |
NPI Number: | 1215099742 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M S CCC SLP L |
License Number: | |
Business Practice Address: | 9519 Birch Ave Mokena, IL - 604489310 |
Business Phone Number: | 7084792131 |
Business Fax Number: | 7084797985 |
Mailing Address: | 9519 Birch Ave, MOKENA |
State: | IL |
Postal Code: | 604489310 |
Phone Number: | 7084792131 |
Fax Number: | 7084797985 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |