Doctor Name: | MR. JUSTIN SIMS |
NPI Number: | 1437356524 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3811 Parnell Ave. Fort Wayne, IN - 46805 |
Business Phone Number: | 2604824651 |
Business Fax Number: | |
Mailing Address: | 934 Heartland Dr., FORT WAYNE |
State: | IN |
Postal Code: | 46825 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |