Healthcare Provider Details

I. General information

NPI: 1134117542
Provider Name (Legal Business Name): SUPERIOR THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 NE 10TH AVE
CRYSTAL RIVER FL
34429-4456
US

IV. Provider business mailing address

315 NE 10TH AVE
CRYSTAL RIVER FL
34429-4456
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-7006
  • Fax: 352-795-7008
Mailing address:
  • Phone: 352-795-7006
  • Fax: 352-795-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH R CAMPBELL
Title or Position: PRESIDENT
Credential: PHDCCC SLP
Phone: 352-795-7006