Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 235Z00000X | Speech-Language Pathologist | | 01059047 | | Yes |
| 2 | 235Z00000X | Speech-Language Pathologist | | 1778 | NEBRASKA | No |
| 3 | 235Z00000X | Speech-Language Pathologist | | SLP0000023 | COLORADO | No |
| 4 | 235Z00000X | Speech-Language Pathologist | | O1-0001603 | DELAWARE | No |
| 5 | 235Z00000X | Speech-Language Pathologist | | SL011063 | PENNSYLVANIA | No |
| 6 | 235Z00000X | Speech-Language Pathologist | | SP-664 | WYOMING | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | SL011063 | OTHER | PENNSYLVANIA | COMMONWEALTH OF PA DEPT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS |
| 2 | SP-664 | OTHER | WYOMING | STATE OF WY BOARD OF EXAMINERS OF SPEECH PATHOLOGY/AUDIOLOGY |
| 3 | 1778 | OTHER | NEBRASKA | STATE OF NE DEPT OF HEALTH AND HUMAN SERVICES DIV OF PUBLIC HEALTH |
| 4 | 0000023 | OTHER | COLORADO | CO DEPT OF REGULATORY AGENCIES DIV OF PROFESSIONS AND OCCUPATIONS |
| 5 | O1-0001603 | OTHER | DELAWARE | STATE OF DE DIV OF PROFESSIONAL REGULATION PROFESSIONAL LICENSE |
