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General NPI Number Information
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NPI Number | 1386062891
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Entity Type | Organization
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Legal Business Name | TREASURE CHAT THERAPY CENTER, INC.
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 8306 COMMERCE WAY 138
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1608
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Country | US
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Telephone | 305-501-0450
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Fax | 786-364-1010
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Provider Business Mailing Address
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Address Line | 8306 COMMERCE WAY 138
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1608
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Country | US
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Telephone | 305-501-0450
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Fax | 786-364-1010
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/DIRECTOR
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Name | MRS. CYNTHIA GONZALEZ
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Credential | M.S. CCC-SLP
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Telephone | 305-501-0450
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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 | SA10399
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License Number State | FL
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