Healthcare Provider Details

I. General information

NPI: 1356318489
Provider Name (Legal Business Name): CORRECTIVE SPEECH AND LANGUAGE THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 S JOHN YOUNG PKWY STE 219
ORLANDO FL
32837-3423
US

IV. Provider business mailing address

12701 S JOHN YOUNG PKWY STE 219
ORLANDO FL
32837-3423
US

V. Phone/Fax

Practice location:
  • Phone: 407-857-6285
  • Fax: 407-857-9566
Mailing address:
  • Phone: 407-857-6285
  • Fax: 407-857-9566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA6112
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSA6112
License Number StateFL

VIII. Authorized Official

Name: MRS. RACHEL LEE SHOCKLEY
Title or Position: PRESIDENT
Credential: CCC-SLP
Phone: 407-857-6285