Healthcare Provider Details

I. General information

NPI: 1053835454
Provider Name (Legal Business Name): APRIL RESCH ST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 GRACE AVE
PANAMA CITY FL
32401-2521
US

IV. Provider business mailing address

927 GRACE AVE
PANAMA CITY FL
32401-2521
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-5371
  • Fax: 850-872-9558
Mailing address:
  • Phone: 850-769-5371
  • Fax: 850-872-9558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ8121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: