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General NPI Number Information
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NPI Number | 1366097628
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Entity Type | Organization
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Legal Business Name | NEW DAY SPEECH THERAPY SERVICES LLC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 2180 A1A S STE 104 DEPREY CHIROPRACTIC BUILDING
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-6523
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Country | US
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Telephone | 904-377-7947
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Fax | 904-471-6236
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Provider Business Mailing Address
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Address Line | 2180 A1A S STE 104 DEPREY CHIROPRACTIC BUILDING
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-6523
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Country | US
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Telephone | 904-377-7947
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Fax | 904-471-6236
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CAROLYN SMALLWOOD
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Credential | SLP
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Telephone | 904-377-7947
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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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