Doctor Name: | KRISTINA MOOTZ |
NPI Number: | 1306155619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP, TSSLD |
License Number: | 58-019606 |
Business Practice Address: | 544 Broadway Ste 3 Monticello, NY - 127011175 |
Business Phone Number: | 8457943500 |
Business Fax Number: | |
Mailing Address: | 52 Mcguire Rd, WOODBOURNE |
State: | NY |
Postal Code: | 127885456 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/04/2010 |
NPI Last Update Date: | 10/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 58-019606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |