Doctor Name: | THOMAS SHORT BLACK |
NPI Number: | 1265600266 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SLP |
License Number: | 7250 |
Business Practice Address: | Berkeley County Board Of Education 401 South Queen Street Martinsburg, WV - 25401 |
Business Phone Number: | 3042673500 |
Business Fax Number: | |
Mailing Address: | 51 Finch Ln, FALLING WATERS |
State: | WV |
Postal Code: | 254194030 |
Phone Number: | 3042749166 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2008 |
NPI Last Update Date: | 02/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7250 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
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 |