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
| License | State | Type | Specialty |
|---|---|---|---|
| 001010 | CT | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Woodbury, CT · Speech-Language Pathologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.