Doctor Name: | MRS. KARLY FORTUNATO |
NPI Number: | 1326419508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 2202008053 |
Business Practice Address: | 935 Capitol Landing Rd Williamsburg, VA - 231854347 |
Business Phone Number: | 7576564533 |
Business Fax Number: | |
Mailing Address: | 220 Olivine Ave, Apt 302 VIRGINIA BEACH |
State: | VA |
Postal Code: | 234624492 |
Phone Number: | 8285501025 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2015 |
NPI Last Update Date: | 10/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202008053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |