Doctor Name: | ELIZABETH A MARTIN |
NPI Number: | 1245508910 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 19435 |
Business Practice Address: | 12625 High Bluff Dr Ste 113 San Diego, CA - 921302053 |
Business Phone Number: | 8584884810 |
Business Fax Number: | |
Mailing Address: | 1621 La Playa Ave Apt 23, SAN DIEGO |
State: | CA |
Postal Code: | 921096473 |
Phone Number: | 5868239587 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 12/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 19435 |
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 |