Doctor Name: | RACHEL PUSTULKA |
NPI Number: | 1861627556 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | 5058 |
Business Practice Address: | 1808 W 30th St Lorain, OH - 440524309 |
Business Phone Number: | 4402823860 |
Business Fax Number: | 4402823860 |
Mailing Address: | 1808 W 30th St, LORAIN |
State: | OH |
Postal Code: | 440524309 |
Phone Number: | 4402823860 |
Fax Number: | 4402823860 |
NPI Enumeration Date: | 05/25/2009 |
NPI Last Update Date: | 05/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5058 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |