Doctor Name: | LORI KAY MITNIK |
NPI Number: | 1497955850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SA5261 |
Business Practice Address: | 1016 Spring Villas Pt Ste. 1030 Winter Springs, FL - 327085258 |
Business Phone Number: | 4076299455 |
Business Fax Number: | 4076299138 |
Mailing Address: | 1016 Spring Villas Pt, Ste. 1030 WINTER SPRINGS |
State: | FL |
Postal Code: | 327085258 |
Phone Number: | 4076299455 |
Fax Number: | 4076299138 |
NPI Enumeration Date: | 07/23/2007 |
NPI Last Update Date: | 07/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA5261 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |