Healthcare Provider Details

I. General information

NPI: 1053907345
Provider Name (Legal Business Name): LONG TIME NO SPEECH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 PENNY LANE
LAKELAND FL
33813
US

IV. Provider business mailing address

4798 S FLORIDA AVE STE 248
LAKELAND FL
33813-2181
US

V. Phone/Fax

Practice location:
  • Phone: 954-646-0013
  • Fax:
Mailing address:
  • Phone: 954-646-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA HULL
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential: MS,CCC-SLP
Phone: 954-646-0013