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General NPI Number Information
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NPI Number | 1356095681
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Entity Type | Organization
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Legal Business Name | SERTOMA KIDS INC.
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Dates
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Enumeration Date | 02/06/2022
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Last Update Date | 02/06/2022
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Provider Practice Location Address
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Address Line | 2750 STICKNEY POINT RD STE 210
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City | SARASOTA
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State | FL
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Zip | 34231-6000
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Country | US
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Telephone | 941-922-1028
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Fax | 941-306-1805
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Provider Business Mailing Address
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Address Line | 2750 STICKNEY POINT RD STE 210
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City | SARASOTA
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State | FL
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Zip | 34231-6000
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Country | US
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Telephone | 941-922-1028
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Fax | 941-306-1805
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | PAM PLANK
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Credential | M.A.CCC-SLP
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Telephone | 941-922-1028
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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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