Doctor Name: | MISS LE ETTA LYNN VANDERPOOL |
NPI Number: | 1508935594 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 10142 |
Business Practice Address: | 1301 W Providence Ave Orange, CA - 928683808 |
Business Phone Number: | 7146393990 |
Business Fax Number: | 7147443841 |
Mailing Address: | 1202 S Berkley St, ANAHEIM |
State: | CA |
Postal Code: | 928044607 |
Phone Number: | 7147610542 |
Fax Number: | |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 10142 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |