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General NPI Number Information
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NPI Number | 1326357542
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Entity Type | Organization
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Legal Business Name | SPEECH THERAPY ASSOCIATES OF FLORIDA, LLC
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 4051 KIRKLAND WAY
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City | LAKE MARY
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State | FL
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Zip | 32746-1840
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Country | US
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Telephone | 727-698-1889
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Fax |
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Provider Business Mailing Address
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Address Line | 4051 KIRKLAND WAY
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City | LAKE MARY
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State | FL
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Zip | 32746-1840
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Country | US
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Telephone | 727-698-1889
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | WENDY WILKES
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Credential | M.A. CCC-SLP
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Telephone | 727-698-1889
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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 | FL
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