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General NPI Number Information
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NPI Number | 1528130622
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Entity Type | Individual
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Provider Name | JOCELYN SUZANNE RICHARDSON M.A., C.C.C.,SLP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 38051 PASCO AVE
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City | DADE CITY
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State | FL
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Zip | 33525-4234
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Country | US
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Telephone | 727-848-6747
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Fax | 727-847-3107
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Provider Business Mailing Address
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Address Line | PO BOX 1502 6646 U.S. HWY 19
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City | NEW PORT RICHEY
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State | FL
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Zip | 34656-1502
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Country | US
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Telephone | 727-848-6747
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Fax | 727-847-3107
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 6269
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License Number State | FL
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