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General NPI Number Information
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NPI Number | 1295961092
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Entity Type | Organization
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Legal Business Name | GREAT BEGINNINGS SPEECH AND LANGUAGE THERAPY CENTER, LLC
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 2949 THORNCREST DR
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City | ORANGE PARK
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State | FL
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Zip | 32065-2252
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Country | US
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Telephone | 904-333-4679
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Fax | 904-291-4678
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Provider Business Mailing Address
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Address Line | 2949 THORNCREST DR
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City | ORANGE PARK
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State | FL
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Zip | 32065-2252
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Country | US
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Telephone | 904-333-4679
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Fax | 904-291-4678
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. MICHELE BELL-BADGER
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Credential | MA, CCC-SLP
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Telephone | 904-333-4679
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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 | SA6136
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License Number State | FL
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