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General NPI Number Information
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NPI Number | 1790689792
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Entity Type | Organization
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Legal Business Name | WHITE SANDS SPEECH AND SWALLOWING, LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 306 E 19TH ST STE A
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City | PANAMA CITY
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State | FL
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Zip | 32405-4743
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Country | US
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Telephone | 308-530-6627
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Fax |
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Provider Business Mailing Address
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Address Line | 140 MERRION RD
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City | SOUTHPORT
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State | FL
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Zip | 32409-1768
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Country | US
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Telephone | 308-530-6627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNA LEE FOSTER
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Credential | M.S., CCC-SLP
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Telephone | 308-530-6627
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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 | NULL
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