Doctor Name: | MARY VAN DEMARK |
NPI Number: | 1356594733 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 004379 |
Business Practice Address: | 21 Spada Dr Saugerties, NY - 124774481 |
Business Phone Number: | 8452470668 |
Business Fax Number: | 8452463710 |
Mailing Address: | Po Box 737, LAKE KATRINE |
State: | NY |
Postal Code: | 124490737 |
Phone Number: | 8452470668 |
Fax Number: | 8452463710 |
NPI Enumeration Date: | 10/29/2008 |
NPI Last Update Date: | 10/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 004379 |
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 |