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General NPI Number Information
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NPI Number | 1639394752
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Entity Type | Individual
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Provider Name | DOLORES BERNKNOPF C.C.C.-S.L.P.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 130 PINE CIR
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City | BOCA RATON
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State | FL
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Zip | 33432-3648
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Country | US
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Telephone | 561-361-0307
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 PARKSIDE CIR S
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City | BOCA RATON
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State | FL
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Zip | 33486-8565
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Country | US
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Telephone | 561-447-1168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA7095
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | SA7095
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License Number State | FL
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