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General NPI Number Information
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NPI Number | 1508467796
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Entity Type | Organization
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Legal Business Name | SMALL TALK INC
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 423 SAINT JOHNS AVE STE 2
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City | PALATKA
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State | FL
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Zip | 32177-4724
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Country | US
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Telephone | 904-733-8255
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Fax | 904-733-5034
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Provider Business Mailing Address
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Address Line | 8777 SAN JOSE BLVD STE 701
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4292
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Country | US
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Telephone | 904-733-8255
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Fax | 904-733-5034
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Authorized Official
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Title or Position | OWNER
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Name | JULIE FOLEY WATTS
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Credential | CCC-SLP
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Telephone | 904-733-8255
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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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