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General NPI Number Information
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NPI Number | 1629002209
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Entity Type | Individual
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Provider Name | JENNIFER CULLER ALSDORF CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 816 FORESTWOOD DR
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City | MINNEOLA
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State | FL
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Zip | 34715-7723
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Country | US
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Telephone | 352-536-2561
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Fax | 407-264-6557
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Provider Business Mailing Address
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Address Line | 816 FORESTWOOD DR
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City | MINNEOLA
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State | FL
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Zip | 34715-7723
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Country | US
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Telephone | 352-536-2561
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Fax | 407-264-6557
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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 8232
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP004307
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License Number State | GA
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