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General NPI Number Information
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NPI Number | 1689555732
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Entity Type | Organization
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Legal Business Name | ECHO BAY THERAPY
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 13504 WILD GINGER ST
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City | RIVERVIEW
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State | FL
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Zip | 33579-6600
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Country | US
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Telephone | 813-328-2656
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Fax |
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Provider Business Mailing Address
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Address Line | 13504 WILD GINGER ST
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City | RIVERVIEW
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State | FL
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Zip | 33579-6600
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Country | US
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Telephone | 813-328-2656
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. KAREN JOHANNA BERNUY
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Credential | MS, SLP
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Telephone | 813-328-2656
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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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