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General NPI Number Information
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NPI Number | 1609531813
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Entity Type | Organization
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Legal Business Name | MILESTONES CHILDRENS THERAPY CENTER
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 111 EAST LAKE MARY BLVD.
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City | SANFORD
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State | FL
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Zip | 32773
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Country | US
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Telephone | 407-203-9492
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Fax |
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Provider Business Mailing Address
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Address Line | 111 EAST LAKE MARY BLVD
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City | SANFORD
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State | FL
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Zip | 32773
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Country | US
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Telephone | 407-203-9492
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGY ASSISTANT
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Name | MISS JEHAN FERESTE MUNOZ
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Credential | SLPA
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Telephone | 407-267-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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