Organization Name: | MOBILE DYSPHAGIA SPECIALISTS |
NPI Number: | 1447621206 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBBIE D HARPER (OWNER) |
Mailing Address: | 2209a E Slade Ln Mahomet |
State: | IL US |
Postal Code: | 618532816 |
Phone Number: | 2173773568 |
Fax Number: | |
NPI Enumeration Date: | 10/19/2015 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.003458 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |