Healthcare Provider Details

I. General information

NPI: 1164340493
Provider Name (Legal Business Name): ESHAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 N PEARL ST
CRESTVIEW FL
32536-2437
US

IV. Provider business mailing address

1328 N PEARL ST
CRESTVIEW FL
32536-2437
US

V. Phone/Fax

Practice location:
  • Phone: 850-257-4766
  • Fax:
Mailing address:
  • Phone: 850-257-4766
  • Fax:

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: JOANNA BROOKE DAVIS
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 850-257-4766