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General NPI Number Information
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NPI Number | 1780814871
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Entity Type | Individual
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Provider Name | LALENA CORWIN M.S., CCC- SLP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 08/08/2009
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Provider Practice Location Address
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Address Line | 170 NORTH CENTER STREET
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5186
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Country | US
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Telephone | 386-672-7113
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Fax |
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Provider Business Mailing Address
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Address Line | 58 BURNING BUSH DRIVE
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City | PALM COAST
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State | FL
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Zip | 32137
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Country | US
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Telephone | 386-597-2808
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Fax |
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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 | SA7037
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License Number State | FL
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