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General NPI Number Information
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NPI Number | 1043543226
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Entity Type | Organization
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Legal Business Name | SPECTRUM SPEECH AND LANGUAGE SERVICES, LLC
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Dates
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Enumeration Date | 09/06/2009
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 12773 W. FOREST HILL BLVD SUITE 1205
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-753-4998
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Fax | 561-753-4911
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Provider Business Mailing Address
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Address Line | 12773 W. FOREST HILL BLVD SUITE 1205
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-753-4998
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Fax | 561-753-4911
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Authorized Official
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Title or Position | OWNER
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Name | ALISON M EVANS
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Credential | CCC-SLP
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Telephone | 561-753-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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