Doctor Name: | JANETTE LEE MUTTILLO |
NPI Number: | 1982027991 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC/MS/SLP/NYS |
License Number: | 003968-1 |
Business Practice Address: | 130 Northwood Cir Rome, NY - 134400704 |
Business Phone Number: | 3153365363 |
Business Fax Number: | |
Mailing Address: | 130 Northwood Cir, ROME |
State: | NY |
Postal Code: | 134400704 |
Phone Number: | 3153365363 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2014 |
NPI Last Update Date: | 01/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 003968-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |