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NPI Code Detail

MEDICARE: WALTER DORRITIE MS, CCC-SLP

MEDICARE: WALTER DORRITIE MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist114527TX
2235Z00000XSpeech-Language PathologistSLP10227NY

General Provider Information

NPI Number : 1790174605
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER DORRITIE MS, CCC-SLP
Provider Business Mailing Address
First Line : 17301 INTERSTATE 35 STE 101
Second Line :
City : BUDA
State : TX
Zip : 78610-5250
Country : US
Telephone Number : 512-461-3617
Fax Number : 914-968-4857
Provider Business Practice Location Address
First Line : 1154 SAW MILL RIVER RD
Second Line :
City : YONKERS
State : NY
Zip : 10710-3210
Country : US
Telephone Number : 914-968-4854
Fax Number : 914-968-4857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2015
Last Update Date : 07/27/2021

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