Doctor Name: | MISS MYRNA DORIS GONZALEZ |
NPI Number: | 1477696326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.CCC-SLP |
License Number: | 005143-1 |
Business Practice Address: | 363 E Main St Centerport, NY - 117211438 |
Business Phone Number: | 6312629187 |
Business Fax Number: | 6312629187 |
Mailing Address: | 363 E Main St, CENTERPORT |
State: | NY |
Postal Code: | 117211438 |
Phone Number: | 6312629187 |
Fax Number: | 6312629187 |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 005143-1 |
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 |