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General NPI Number Information
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NPI Number | 1508558875
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Entity Type | Organization
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Legal Business Name | GOODLAD THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 3408 57TH ST E
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City | BRADENTON
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State | FL
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Zip | 34208-6804
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Country | US
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Telephone | 407-401-4008
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Fax |
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Provider Business Mailing Address
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Address Line | 3408 57TH ST E
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City | BRADENTON
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State | FL
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Zip | 34208-6804
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Country | US
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Telephone | 407-401-4008
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | JAMI HOLLINGSWORTH GOODLAD
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Credential | MA, CCC-SLP
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Telephone | 407-401-4008
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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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