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General NPI Number Information
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NPI Number | 1649565284
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Entity Type | Organization
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Legal Business Name | ACE THERAPY GROUP, LLC
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Dates
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Enumeration Date | 06/11/2011
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Last Update Date | 07/23/2016
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Provider Practice Location Address
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Address Line | 21929 CRICKLEWOOD TER
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City | BOCA RATON
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State | FL
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Zip | 33428-3053
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Country | US
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Telephone | 954-298-7591
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Fax | 561-288-6000
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Provider Business Mailing Address
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Address Line | 21929 CRICKLEWOOD TER
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City | BOCA RATON
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State | FL
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Zip | 33428-3053
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Country | US
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Telephone | 954-298-7591
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Fax | 561-288-6000
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | AMY ETKIE
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Credential | M.S. CCC-SLP
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Telephone | 954-298-7591
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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 10046
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License Number State | FL
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