Healthcare Provider Details

I. General information

NPI: 1023928157
Provider Name (Legal Business Name): ALLY NICOLE EARLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4335 WILKINSON RD
SARASOTA FL
34233-1327
US

IV. Provider business mailing address

752 CEDARCREST CT
SARASOTA FL
34232-2494
US

V. Phone/Fax

Practice location:
  • Phone: 941-208-3130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI9051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: