Doctor Name: | MRS. AMANITA LUBA BRAZIL |
NPI Number: | 1336453539 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | SL010044 |
Business Practice Address: | 68 W Donegal St Mount Joy, PA - 175522220 |
Business Phone Number: | 8144503012 |
Business Fax Number: | |
Mailing Address: | 68 W Donegal St, MOUNT JOY |
State: | PA |
Postal Code: | 175522220 |
Phone Number: | 8144503012 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2010 |
NPI Last Update Date: | 07/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL010044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |