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General NPI Number Information
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NPI Number | 1316781305
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Entity Type | Organization
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Legal Business Name | DEBARY SPEECH TEACH, LLC
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 180 TREEMONTE DR
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City | ORANGE CITY
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State | FL
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Zip | 32763-7953
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Country | US
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Telephone | 386-228-7285
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Fax | 386-742-7272
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Provider Business Mailing Address
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Address Line | 105 SAN LUCIA DR
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City | DEBARY
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State | FL
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Zip | 32713-5420
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Country | US
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Telephone | 386-228-7285
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Fax | 386-742-7272
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. HEATHER H LASHER
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Credential | MA, CCC-SLP
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Telephone | 386-228-7285
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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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