Doctor Name: | MISS SHOSHANNA BETH WILBUR |
NPI Number: | 1326255738 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | LL00003501 |
Business Practice Address: | 15100 Se 38th St # 751 Bellevue, WA - 980061728 |
Business Phone Number: | 4258900998 |
Business Fax Number: | 2063383560 |
Mailing Address: | 15100 Se 38th St # 751, BELLEVUE |
State: | WA |
Postal Code: | 980061728 |
Phone Number: | 4258900998 |
Fax Number: | 2063383560 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 11/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL00003501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |