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General NPI Number Information
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NPI Number | 1407406515
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Entity Type | Organization
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Legal Business Name | ON THE GO SPEECH
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 144 NW 3RD AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33444-2624
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Country | US
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Telephone | 754-264-8656
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Fax |
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Provider Business Mailing Address
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Address Line | 10725 PINE TREE TER
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4907
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Country | US
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Telephone | 347-885-7845
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTA WOJCIK
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Credential | MA, CCC-SLP
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Telephone | 347-885-7845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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