Doctor Name: | WAYNE FLEWELLING |
NPI Number: | 1932588191 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC/SP |
License Number: | 8011026 |
Business Practice Address: | 142 Hudson Ter Pittsford, VT - 057639438 |
Business Phone Number: | 8027793539 |
Business Fax Number: | |
Mailing Address: | 142 Hudson Ter, PITTSFORD |
State: | VT |
Postal Code: | 057639438 |
Phone Number: | 8027793539 |
Fax Number: | |
NPI Enumeration Date: | 05/21/2015 |
NPI Last Update Date: | 05/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8011026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
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 |