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General NPI Number Information
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NPI Number | 1538259270
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Entity Type | Organization
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Legal Business Name | PEDIA-SPEECH, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11435 W PALMETTO PARK RD STE J
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City | BOCA RATON
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State | FL
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Zip | 33428-2630
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Country | US
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Telephone | 561-702-6141
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Fax | 561-361-9179
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Provider Business Mailing Address
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Address Line | 5668 PINECREST CIR
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City | BOCA RATON
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State | FL
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Zip | 33433-5331
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Country | US
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Telephone | 561-702-6141
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Fax | 561-361-9179
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ALLISON CORI KATLIN
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Credential | MS, CCC-SLP
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Telephone | 561-702-6141
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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 5357
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License Number State | FL
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