MEDICARE: KIDS CHAT THERAPY

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
1	235Z00000X	Speech-Language Pathologist	SA 7164	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356597165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS CHAT THERAPY

Provider Business Mailing Address
First Line	:	7100 SW 99TH AVE
Second Line	:	# 201
City	:	MIAMI
State	:	FL
Zip	:	33173-4667
Country	:	US
Telephone Number	:	305-491-1032
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 SW 99TH AVE
Second Line	:	# 201
City	:	MIAMI
State	:	FL
Zip	:	33173-4667
Country	:	US
Telephone Number	:	305-491-1032
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/SPEECH PATHOLOGIST
Name	:	MRS. JENNY ARELY MONTAGNER
Credential	:	M.S., CCC-SLP
Telephone Number	:	305-491-1032

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	08/12/2008

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Directions to “KIDS CHAT THERAPY ” Practice Location

Language	Start Address	Practice Location

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