Healthcare Provider Details

I. General information

NPI: 1457270704
Provider Name (Legal Business Name): SPEECH SPROUTS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 W RUNYON LOOP
BEVERLY HILLS FL
34465-4294
US

IV. Provider business mailing address

580 W RUNYON LOOP
BEVERLY HILLS FL
34465-4294
US

V. Phone/Fax

Practice location:
  • Phone: 989-305-7409
  • Fax: 352-352-2963
Mailing address:
  • Phone: 989-305-7409
  • Fax: 352-352-2963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENNA GARRICK
Title or Position: OWNER/SPEECH LANGUAGE PATHOLOGIST
Credential: M.S. CCC-SLP
Phone: 989-305-7409