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General NPI Number Information
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NPI Number | 1396306874
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY SPEECH, PHYSICAL, AND OCCUPATIONAL THERAPIES
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 1502 N DONNELLY ST STE 109
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City | MOUNT DORA
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State | FL
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Zip | 32757-2846
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Country | US
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Telephone | 352-729-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 N DONNELLY ST STE 109
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City | MOUNT DORA
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State | FL
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Zip | 32757-2846
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Country | US
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Telephone | 352-729-2277
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARLYNE JEAN-PIERRE
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Credential |
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Telephone | 708-228-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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