Doctor Name: | AMANDA MARIE PULVER |
NPI Number: | 1841638673 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | 17998 |
Business Practice Address: | 1 Tidewater Cv Buena Park, CA - 906211661 |
Business Phone Number: | 5628820909 |
Business Fax Number: | 7145217523 |
Mailing Address: | 1 Tidewater Cv, BUENA PARK |
State: | CA |
Postal Code: | 906211661 |
Phone Number: | 5628820909 |
Fax Number: | 7145217523 |
NPI Enumeration Date: | 06/14/2013 |
NPI Last Update Date: | 06/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 17998 |
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 |