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General NPI Number Information
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NPI Number | 1396299780
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Entity Type | Organization
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Legal Business Name | PREMIER SPEECH & LANGUAGE ASSOCIATES
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 10/11/2020
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Provider Practice Location Address
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Address Line | 341 S BROMELIAD
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-7737
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Country | US
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Telephone | 352-246-4003
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Fax | 561-370-6062
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Provider Business Mailing Address
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Address Line | 341 S BROMELIAD
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-7737
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Country | US
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Telephone | 352-246-4003
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Fax | 561-370-6062
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Authorized Official
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Title or Position | PRESIDENT
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Name | STACEE L ELLIOTT
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Credential | M.S., CCC-SLP
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Telephone | 352-246-4003
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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 | SA 14625
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License Number State | FL
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