Healthcare Provider Details

I. General information

NPI: 1245636919
Provider Name (Legal Business Name): COMMUNICATION COACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9825 COBBLESTONE LAKES CT
BOYNTON BEACH FL
33472-4443
US

IV. Provider business mailing address

9825 COBBLESTONE LAKES CT
BOYNTON BEACH FL
33472-4443
US

V. Phone/Fax

Practice location:
  • Phone: 954-867-4870
  • Fax:
Mailing address:
  • Phone: 954-867-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberSA11699
License Number StateFL

VIII. Authorized Official

Name: MRS. JENNA P KAPLAN
Title or Position: PRESIDENT
Credential: M.S. SLP CCC
Phone: 954-867-4870