Doctor Name: | CHRISTOPHER LOLL |
NPI Number: | 1215329842 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 21401 |
Business Practice Address: | 139 2nd St Gilroy, CA - 950205102 |
Business Phone Number: | 4088477900 |
Business Fax Number: | 4088473757 |
Mailing Address: | 260 Berry Ct Apt 18, MORGAN HILL |
State: | CA |
Postal Code: | 950374226 |
Phone Number: | 6504381985 |
Fax Number: | |
NPI Enumeration Date: | 02/18/2015 |
NPI Last Update Date: | 02/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 21401 |
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 |