Doctor Name: | EILEEN SULLIVAN MIJARES |
NPI Number: | 1962548487 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SA7115 |
Business Practice Address: | Cmr 420 Box 2395 Apo, AE - 090630024 |
Business Phone Number: | 3059094882 |
Business Fax Number: | |
Mailing Address: | Cmr 420 Box 2395, APO |
State: | AE |
Postal Code: | 090630024 |
Phone Number: | 3059094882 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 08/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA7115 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |