| NPI | 1972964468 |
|---|---|
| Other Name | SAN DIEGO STATE UNIVERSITY SPEECH, LANGUAGE AND HEARING CLINIC |
| Entity Type | Organization |
| Authorized Contact | AGNES WONG NICKERSON Associate VP Of Financial Operation 619-594-6017 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |