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General NPI Number Information
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NPI Number | 1588480693
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Entity Type | Organization
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Legal Business Name | TINY BUBBLES SLP LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 173 NOBLE CREEK RD
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City | WOODRUFF
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State | SC
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Zip | 29388-8446
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Country | US
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Telephone | 787-245-5379
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Fax |
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Provider Business Mailing Address
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Address Line | 173 NOBLE CREEK RD
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City | WOODRUFF
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State | SC
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Zip | 29388-8446
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Country | US
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Telephone | 787-245-5379
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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 | ELBANGELIS ORTIZ MORALES
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Credential | SLP-CCC
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Telephone | 787-245-5379
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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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