Healthcare Provider Details

I. General information

NPI: 1174460596
Provider Name (Legal Business Name): WILLOW AND WORDS SPEECH AND LANGUAGE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8112 W VINCENT LN
CRYSTAL RIVER FL
34428-6914
US

IV. Provider business mailing address

8112 W VINCENT LN
CRYSTAL RIVER FL
34428-6914
US

V. Phone/Fax

Practice location:
  • Phone: 337-366-4544
  • Fax:
Mailing address:
  • Phone:
  • 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: RUTH YOUNG
Title or Position: OWNER
Credential: SLP
Phone: 337-366-4544