MEDICARE: MIND2MOUTH, LLC

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	261QH0700X	Hearing and Speech Clinic/Center

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	:	1790530418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND2MOUTH, LLC

Provider Business Mailing Address
First Line	:	2601 NE 27TH ST
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-8320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 NE 27TH ST
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-8320
Country	:	US
Telephone Number	:	412-445-0884
Fax Number	:

Authorized Official
Title or Position	:	MS, CCC-SLP
Name	:	SHERRY ANTOINE
Credential	:
Telephone Number	:	412-445-0884

Provider Enumeration Date	:	04/17/2024
Last Update Date	:	04/17/2024

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Directions to “MIND2MOUTH, LLC ” Practice Location

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