Healthcare Provider Details

I. General information

NPI: 1497725071
Provider Name (Legal Business Name): BUILDING BLOCKS OF SPEECH THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 MARCO DR NE
ST PETERSBURG FL
33702-2727
US

IV. Provider business mailing address

982 MARCO DR NE
ST PETERSBURG FL
33702-2727
US

V. Phone/Fax

Practice location:
  • Phone: 727-521-6121
  • Fax: 727-521-6020
Mailing address:
  • Phone: 727-521-6121
  • Fax: 727-521-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 5897
License Number StateFL

VIII. Authorized Official

Name: MRS. ASHLEIGH G. THORNTON
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential: MS CCC-SLP
Phone: 727-521-6121