Doctor Name: | PITU HALDER |
NPI Number: | 1922436294 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 2004027776 |
Business Practice Address: | 3108 W Truman Blvd Jefferson City, MO - 651094918 |
Business Phone Number: | 5738933063 |
Business Fax Number: | 5738931944 |
Mailing Address: | 121 Palisades Dr, JEFFERSON CITY |
State: | MO |
Postal Code: | 651096182 |
Phone Number: | 5738934274 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2013 |
NPI Last Update Date: | 10/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2004027776 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |