Doctor Name: | MARY KATHY VAZZANO |
NPI Number: | 1710242003 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 146.009295 |
Business Practice Address: | 1000 S Lorraine Rd #204 Wheaton, IL - 601896970 |
Business Phone Number: | 6303032957 |
Business Fax Number: | |
Mailing Address: | 1000 S Lorraine Rd, #204 WHEATON |
State: | IL |
Postal Code: | 601896970 |
Phone Number: | 6303032957 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2012 |
NPI Last Update Date: | 07/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.009295 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |