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General NPI Number Information
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NPI Number | 1801213673
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Entity Type | Organization
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Legal Business Name | SEAGLASS SPEECH THERAPY, PLLC
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 120 HIDDEN HOLLOW DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6000
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Country | US
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Telephone | 561-758-5859
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Fax |
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Provider Business Mailing Address
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Address Line | 120 HIDDEN HOLLOW DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6000
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Country | US
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Telephone | 561-758-5859
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | CARA LOUISE MCALLISTER
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Credential | M.A. CCC-SLP
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Telephone | 561-758-5859
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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 | SA11342
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License Number State | FL
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