Doctor Name: | NORIKO MIZUHARA |
NPI Number: | 1801169644 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SP 19346 |
Business Practice Address: | 11381 Mount Wallace Ct Rancho Cucamonga, CA - 917376557 |
Business Phone Number: | 9099448411 |
Business Fax Number: | 9096080088 |
Mailing Address: | 11381 Mount Wallace Ct, RANCHO CUCAMONGA |
State: | CA |
Postal Code: | 917376557 |
Phone Number: | 9099448411 |
Fax Number: | 9096080088 |
NPI Enumeration Date: | 02/09/2012 |
NPI Last Update Date: | 02/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP 19346 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |