Organization Name: | DAVID SCOTT ELAM |
NPI Number: | 1215139068 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID SCOTT ELAM (DIRECTOR) |
Mailing Address: | 191 Burton Mesa Blvd #d Lompoc |
State: | CA US |
Postal Code: | 934361400 |
Phone Number: | 8057334542 |
Fax Number: | 8057334392 |
NPI Enumeration Date: | 06/04/2007 |
NPI Last Update Date: | 05/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP5420 |
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 |