Doctor Name: | MRS. DOLORES O'BRIEN |
NPI Number: | 1548530876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SP |
License Number: | 005737 |
Business Practice Address: | 946 State Route 17k Montgomery, NY - 125492213 |
Business Phone Number: | 8454572400 |
Business Fax Number: | |
Mailing Address: | 19 Didio Ln, MONTGOMERY |
State: | NY |
Postal Code: | 125492713 |
Phone Number: | 8455678390 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2012 |
NPI Last Update Date: | 01/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 005737 |
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 |