Healthcare Provider Details
I. General information
NPI: 1275334674
Provider Name (Legal Business Name): SPEAK YOUR MIND SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 BELLE FONTAINE CIR APT 121
LAKE MARY FL
32746-2267
US
IV. Provider business mailing address
201 BELLE FONTAINE CIR APT 121
LAKE MARY FL
32746-2267
US
V. Phone/Fax
- Phone: 305-927-7855
- Fax:
- Phone: 305-927-7855
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THAYLA
PATRICIA
BUERGO
Title or Position: OWNER/SERVICE PROVIDER
Credential:
Phone: 305-927-7855