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General NPI Number Information
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NPI Number | 1093346058
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Entity Type | Organization
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Legal Business Name | BEACH SPEECH THERAPY
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 309 E 21ST AVE STE H
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City | GULF SHORES
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State | AL
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Zip | 36542-3657
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Country | US
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Telephone | 251-610-8000
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Fax | 251-317-3321
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Provider Business Mailing Address
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Address Line | 929 E 23RD AVE
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City | GULF SHORES
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State | AL
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Zip | 36542-3125
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Country | US
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Telephone | 251-610-8000
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | MRS. LIA DOUGLAS
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Credential | MS CCC SLP
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Telephone | 251-610-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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