Provider Demographics
NPI:1740428523
Name:TOMCHO, NATALIE ANNE (CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ANNE
Last Name:TOMCHO
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 WOODBERRY DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3023
Mailing Address - Country:US
Mailing Address - Phone:607-760-9947
Mailing Address - Fax:
Practice Address - Street 1:3208 WOODBERRY DR
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3023
Practice Address - Country:US
Practice Address - Phone:607-760-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-01
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06134-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist