Doctor Name: | WHITNEY PERDOMO |
NPI Number: | 1548520083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | 106804 |
Business Practice Address: | 23110 Ford Rd Ste A Porter, TX - 773655416 |
Business Phone Number: | 2813543383 |
Business Fax Number: | 2813546750 |
Mailing Address: | Po Box 9, PORTER |
State: | TX |
Postal Code: | 773650009 |
Phone Number: | 2813543383 |
Fax Number: | 2813546750 |
NPI Enumeration Date: | 05/17/2012 |
NPI Last Update Date: | 05/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 106804 |
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 |