Doctor Name: | JUDY A NORDSTROM |
NPI Number: | 1730368358 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SL001963L |
Business Practice Address: | 625 W Edwin St Williamsport, PA - 177014909 |
Business Phone Number: | 5703260565 |
Business Fax Number: | |
Mailing Address: | 625 W Edwin St, WILLIAMSPORT |
State: | PA |
Postal Code: | 177014909 |
Phone Number: | 5703260565 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2007 |
NPI Last Update Date: | 10/31/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL001963L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
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 |