Doctor Name: | WILLIAM HUMPHREY |
NPI Number: | 1750710158 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MACCC/SLP |
License Number: | 7101002482 |
Business Practice Address: | 7855 Currier Dr Portage, MI - 490024314 |
Business Phone Number: | 2693237748 |
Business Fax Number: | 2693231908 |
Mailing Address: | Po Box 781, STURGIS |
State: | MI |
Postal Code: | 490910781 |
Phone Number: | 2696895972 |
Fax Number: | |
NPI Enumeration Date: | 11/06/2013 |
NPI Last Update Date: | 11/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7101002482 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |