MEDICARE: ABC SPEECH & LANGUAGE THERAPY, INC.

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

General Provider Information

NPI Number	:	1851625016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC SPEECH & LANGUAGE THERAPY, INC.

Provider Business Mailing Address
First Line	:	5703 SW 87TH AVE
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5703 SW 87TH AVE
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33328-5906
Country	:	US
Telephone Number	:	954-882-4312
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SONDRA M PIERCE
Credential	:
Telephone Number	:	954-882-4312

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	09/21/2009

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