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General NPI Number Information
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NPI Number | 1356563282
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Entity Type | Individual
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Provider Name | COLLEEN MARY MARTENS ENDRIZZI PHD (IS)M.S, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 130 HEIGHTS AVE
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City | INVERNESS
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State | FL
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Zip | 34452-4571
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Country | US
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Telephone | 352-419-6570
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Fax | 888-639-2521
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Provider Business Mailing Address
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Address Line | 11565 E GULF TO LAKE HWY
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City | INVERNESS
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State | FL
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Zip | 34450-5634
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Country | US
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Telephone | 612-554-5005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15428
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License Number State | FL
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