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General NPI Number Information
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NPI Number | 1356640106
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Entity Type | Organization
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Legal Business Name | CLERVAUD SPEECH THERAPY SERVICES INC.
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Dates
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Enumeration Date | 03/19/2011
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Last Update Date | 03/19/2011
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Provider Practice Location Address
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Address Line | 7171 SIENNA RIDGE LN
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City | LAUDERHILL
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State | FL
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Zip | 33319-4313
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Country | US
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Telephone | 305-905-8818
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Fax | 954-533-1481
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Provider Business Mailing Address
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Address Line | 7171 SIENNA RIDGE LN
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City | LAUDERHILL
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State | FL
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Zip | 33319-4313
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Country | US
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Telephone | 305-905-8818
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Fax | 954-533-1481
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. KATIA CLERVAUD
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Credential | M.S., CCC-SLP
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Telephone | 305-905-8818
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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 | SA10506
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License Number State | FL
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