Doctor Name: | LUANN COLLINS MEZZATESTA |
NPI Number: | 1326235540 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3592 |
Business Practice Address: | 8247 Ocean Hwy Pawleys Island, SC - 295856994 |
Business Phone Number: | 8432359748 |
Business Fax Number: | |
Mailing Address: | Po Box 421718, GEORGETOWN |
State: | SC |
Postal Code: | 294424203 |
Phone Number: | 8432359748 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2007 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3592 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |