Doctor Name: | DR. JENIFFER DUTKA |
NPI Number: | 1407002769 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | SLP01121865 |
Business Practice Address: | 407 Greyfield Ln Sandy Springs, GA - 303502075 |
Business Phone Number: | 6782007214 |
Business Fax Number: | 4047853706 |
Mailing Address: | 407 Greyfield Ln, SANDY SPRINGS |
State: | GA |
Postal Code: | 303502075 |
Phone Number: | 6782007214 |
Fax Number: | 4047853706 |
NPI Enumeration Date: | 08/18/2008 |
NPI Last Update Date: | 09/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP01121865 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |