Organization Name: | YOUR SPEECH THERAPIST, INC. |
NPI Number: | 1710255492 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARC H MITNICK (PRES) |
Mailing Address: | 8178 Sandpiper Glen Drive Lake Worth |
State: | FL US |
Postal Code: | 334676946 |
Phone Number: | 9547788867 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 06/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA2045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |