Doctor Name: | DR. IRIS MAYBRUCK |
NPI Number: | 1215368295 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SPEECH PATHOLOGIST |
License Number: | 2784 |
Business Practice Address: | 1920 Pandora Ave #4 Los Angeles, CA - 900255060 |
Business Phone Number: | 3104740819 |
Business Fax Number: | 3104752864 |
Mailing Address: | 1920 Pandora Ave, LOS ANGELES |
State: | CA |
Postal Code: | 900255060 |
Phone Number: | 3104740819 |
Fax Number: | 3104752864 |
NPI Enumeration Date: | 12/02/2013 |
NPI Last Update Date: | 12/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2784 |
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 |