Amy Dumoch

Individual provider Active NPI Speech-Language Pathologist · Woodbury, CT

NPI 1255753752 · NPPES record last updated Jan 17, 2014

Key facts

NPI
1255753752
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
001010 (CT)
Practice address
125 Hoop Pole Hill Rd
Woodbury, CT 06798-1926
Phone
(203) 263-2709
Fax
(203) 263-2709
NPI assigned
Jan 17, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001010CTMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 001010 CT Yes

Addresses

Primary practice location

125 Hoop Pole Hill Rd
Woodbury, CT 06798-1926

Mailing address

125 Hoop Pole Hill Rd
Woodbury, CT 06798-1926
Phone (203) 263-2206

Other providers in Woodbury, CT

All providers in Woodbury, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.