Doctor Name: | NITZSCHIA SANTIAGO-TAM |
NPI Number: | 1528315405 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 108039 |
Business Practice Address: | 190 Civic Cir Suite 250 Lewisville, TX - 750673424 |
Business Phone Number: | 9722191200 |
Business Fax Number: | 9723174422 |
Mailing Address: | 190 Civic Cir, Suite 250 LEWISVILLE |
State: | TX |
Postal Code: | 750673424 |
Phone Number: | 9722191200 |
Fax Number: | 9723174422 |
NPI Enumeration Date: | 08/09/2012 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 108039 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |