Doctor Name: | DR. PATRICIA WOLF GOMOLA |
NPI Number: | 1558417402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 002266 |
Business Practice Address: | 272 S Main St Middletown, CT - 064574211 |
Business Phone Number: | 8603479586 |
Business Fax Number: | 8603477626 |
Mailing Address: | 272 S Main St, MIDDLETOWN |
State: | CT |
Postal Code: | 064574211 |
Phone Number: | 8603479586 |
Fax Number: | 8603477626 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 002266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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 |