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General NPI Number Information
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NPI Number | 1053755090
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Entity Type | Organization
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Legal Business Name | SPEAKEASY FOR KIDS INC.
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 9415 SW 72ND ST STE 131
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City | MIAMI
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State | FL
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Zip | 33173-5492
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Country | US
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Telephone | 786-953-8389
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Fax | 786-953-8483
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Provider Business Mailing Address
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Address Line | 9415 SW 72ND ST STE 131
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City | MIAMI
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State | FL
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Zip | 33173-5492
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Country | US
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Telephone | 786-953-8389
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Fax | 786-953-8483
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Authorized Official
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Title or Position | PRESIDENT
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Name | CORAL C DU QUESNE
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Credential |
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Telephone | 305-803-5018
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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 | SA8469
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License Number State | FL
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