Healthcare Provider Details

I. General information

NPI: 1356628341
Provider Name (Legal Business Name): BETSY GERMAIN B.S. SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 TAFT ST STE 200
PEMBROKE PINES FL
33026-4387
US

IV. Provider business mailing address

12301 TAFT ST STE 200
PEMBROKE PINES FL
33026-4387
US

V. Phone/Fax

Practice location:
  • Phone: 954-312-3449
  • Fax: 954-251-2752
Mailing address:
  • Phone: 954-312-3449
  • Fax: 954-251-2752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI 1585
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: