Healthcare Provider Details

I. General information

NPI: 1164901534
Provider Name (Legal Business Name): JMS SPEECH THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 CULVER DR NE STE 6
PALM BAY FL
32907-1104
US

IV. Provider business mailing address

4923 FLORA DR
MELBOURNE FL
32934-7846
US

V. Phone/Fax

Practice location:
  • Phone: 321-536-0107
  • Fax: 321-428-5004
Mailing address:
  • Phone: 321-536-0107
  • Fax: 321-428-5004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA12229
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMIE SCHEPP
Title or Position: OWNER
Credential: MS CCC SLP
Phone: 321-536-0107