Provider Demographics
NPI:1366597072
Name:POLITE, DOROTHY M
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:M
Last Name:POLITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5131
Mailing Address - Country:US
Mailing Address - Phone:310-566-7479
Mailing Address - Fax:310-566-7487
Practice Address - Street 1:13101 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5131
Practice Address - Country:US
Practice Address - Phone:310-566-7479
Practice Address - Fax:310-566-7487
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist