Doctor Name: | MRS. VICKI JUNE DORNBERGER |
NPI Number: | 1679727085 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA SLP |
License Number: | 004116-1 |
Business Practice Address: | 284 Rt 54 East Lake Rd Penn Yan, NY - 145279406 |
Business Phone Number: | 3155367405 |
Business Fax Number: | |
Mailing Address: | 284 Rt 54 East Lake Rd, PENN YAN |
State: | NY |
Postal Code: | 145279406 |
Phone Number: | 3155367405 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2008 |
NPI Last Update Date: | 11/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 004116-1 |
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 |