Organization Name: | SPEECH PATHOLOGY SERVICES OF MARIN SONOMA INCORPORTATED |
NPI Number: | 1801019773 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELAINE STEVICK (CEO CLINICAL DIRECTOR) |
Mailing Address: | 1301 Redwood Way Suite 165 Petaluma |
State: | CA US |
Postal Code: | 949541107 |
Phone Number: | 7077636419 |
Fax Number: | 7077632537 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |