=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720717291
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY PATHWAYS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2022
-----------------------------------------------------
Last Update Date | 06/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7338 STEER BLADE DR
-----------------------------------------------------
City | ZEPHYRHILLS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33541-9162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-360-6775
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7338 STEER BLADE DR
-----------------------------------------------------
City | ZEPHYRHILLS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33541-9162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | STEPHANIE LANE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 321-360-6775
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------