Doctor Name: | MAUREEN VAN DER HEYDEN |
NPI Number: | 1801285010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SP17958 |
Business Practice Address: | 13067 Arborwalk Ln Tustin, CA - 927828042 |
Business Phone Number: | 7142635092 |
Business Fax Number: | |
Mailing Address: | 13067 Arborwalk Ln, TUSTIN |
State: | CA |
Postal Code: | 927828042 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/12/2015 |
NPI Last Update Date: | 01/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP17958 |
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 |