| Doctor Name: | MR. THEODORE LEVATTER |
| NPI Number: | 1255764551 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., CCC |
| License Number: | SP5451 |
| Business Practice Address: | 55 Auburn Ave Sierra Madre, CA - 910241847 |
| Business Phone Number: | 6267572817 |
| Business Fax Number: | |
| Mailing Address: | 6716 Clybourn Ave, #238 N HOLLYWOOD |
| State: | CA |
| Postal Code: | 916062264 |
| Phone Number: | 8183087984 |
| Fax Number: | 8183087984 |
| NPI Enumeration Date: | 08/10/2013 |
| NPI Last Update Date: | 08/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP5451 |
| 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 |