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General NPI Number Information
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NPI Number | 1336710623
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Entity Type | Organization
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Legal Business Name | SPEECH AND OCCUPATIONAL SPECIALISTS, LLC
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 1050 US HIGHWAY 27 STE 10
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City | CLERMONT
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State | FL
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Zip | 34714-7508
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Country | US
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Telephone | 407-399-6556
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Fax | 407-654-5829
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Provider Business Mailing Address
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Address Line | 1201 WINTER GARDEN VINELAND RD STE 10
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4380
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Country | US
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Telephone | 407-399-6556
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Fax | 407-654-5829
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JENNIFER OLESEN
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Credential |
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Telephone | 407-399-6556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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