Doctor Name: | MRS. THERESE MARIE LOUTHERBACK |
NPI Number: | 1558503714 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | SP1178 |
Business Practice Address: | 53 Cambria Dr Corona Del Mar, CA - 926251004 |
Business Phone Number: | 7149280858 |
Business Fax Number: | |
Mailing Address: | 53 Cambria Dr, CORONA DEL MAR |
State: | CA |
Postal Code: | 926251004 |
Phone Number: | 7149280858 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2009 |
NPI Last Update Date: | 04/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP1178 |
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 |