Provider Demographics
NPI:1215698576
Name:WATERFALL SPEECH & SWALLOWING THERAPY PLLC
Entity type:Organization
Organization Name:WATERFALL SPEECH & SWALLOWING THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC/SLP
Authorized Official - Phone:716-221-0542
Mailing Address - Street 1:300 N FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5056
Mailing Address - Country:US
Mailing Address - Phone:716-221-0542
Mailing Address - Fax:866-504-5888
Practice Address - Street 1:300 N FOREST RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5056
Practice Address - Country:US
Practice Address - Phone:716-221-0542
Practice Address - Fax:866-504-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty