Healthcare Provider Details

I. General information

NPI: 1477781714
Provider Name (Legal Business Name): YVETTE KOTTMAN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 NORTH ST
MILFORD DE
19963-2707
US

IV. Provider business mailing address

705 NORTH ST
MILFORD DE
19963-2707
US

V. Phone/Fax

Practice location:
  • Phone: 302-424-1770
  • Fax:
Mailing address:
  • Phone: 302-424-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01-0000994
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: