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General NPI Number Information
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NPI Number | 1356318489
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Entity Type | Organization
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Legal Business Name | CORRECTIVE SPEECH AND LANGUAGE THERAPY, INC.
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 14055 TOWN LOOP BLVD SUITE 300
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City | ORLANDO
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State | FL
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Zip | 32837-6105
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Country | US
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Telephone | 407-857-6285
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Fax | 407-857-9566
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Provider Business Mailing Address
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Address Line | 14055 TOWN LOOP BLVD SUITE 300
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City | ORLANDO
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State | FL
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Zip | 32837-6105
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Country | US
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Telephone | 407-857-6285
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Fax | 407-857-9566
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RACHEL LEE SHOCKLEY
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Credential | CCC-SLP
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Telephone | 407-857-6285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SA6112
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA6112
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License Number State | FL
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