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General NPI Number Information
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NPI Number | 1104354224
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Entity Type | Organization
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Legal Business Name | ACORN AND OAK INC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5485 WILES RD STE 402
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4221
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Country | US
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Telephone | 954-621-3669
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Fax |
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Provider Business Mailing Address
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Address Line | 5485 WILES RD STE 402
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4221
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Country | US
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Telephone | 954-621-3669
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELODY EREZ
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Credential | MS CCC-SLP
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Telephone | 954-803-5559
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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 | SA15420
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SA15420
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License Number State | FL
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