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General NPI Number Information
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NPI Number | 1588165476
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Entity Type | Organization
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Legal Business Name | ORANGE BLOSSOM SPEECH AND FEEDING, LLC
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Dates
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Enumeration Date | 02/26/2018
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Last Update Date | 02/26/2018
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Provider Practice Location Address
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Address Line | 157 SUNRISE COVE CIR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-0003
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Country | US
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Telephone | 954-816-8083
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Fax |
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Provider Business Mailing Address
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Address Line | 157 SUNRISE COVE CIR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-0003
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Country | US
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Telephone | 954-816-8083
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Fax |
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Authorized Official
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Title or Position | OWNER/SLP
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Name | CINDY LANE PARR
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Credential |
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Telephone | 954-816-8083
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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 | 15958
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License Number State | FL
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