Provider Demographics
NPI:1427281245
Name:CORWIN-GOTIMER, MARIA (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CORWIN-GOTIMER
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 MENDON RD APT 58
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3494
Mailing Address - Country:US
Mailing Address - Phone:401-658-1530
Mailing Address - Fax:
Practice Address - Street 1:100 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-7724
Practice Address - Country:US
Practice Address - Phone:401-724-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist