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NPI Code Detail

MEDICARE: GRACE THERAPIES

MEDICARE: GRACE THERAPIES
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
12355S0801XSpeech-Language AssistantSI 2529FL

General Provider Information

NPI Number : 1881072411
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE THERAPIES
Provider Business Mailing Address
First Line : 10470 SW WATERWAY LN
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34987-2494
Country : US
Telephone Number : 772-812-0491
Fax Number :
Provider Business Practice Location Address
First Line : 4715 KIRBY LOOP RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5345
Country : US
Telephone Number : 772-461-9954
Fax Number :
Authorized Official
Title or Position : SPEECH-LANGUAGE PATHOLOGIST ASST
Name : MISS EMILY ANN SORICELLI
Credential : SLPA
Telephone Number : 772-812-0491
Provider Enumeration Date : 05/14/2015
Last Update Date : 05/14/2015

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Directions to “GRACE THERAPIES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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