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General NPI Number Information
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NPI Number | 1821053612
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Entity Type | Organization
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Legal Business Name | CHILDLIFE THERAPY, L.L.C.
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2538 FLOWERING DOGWOOD DR
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City | ORLANDO
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State | FL
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Zip | 32828-4828
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Country | US
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Telephone | 407-977-4448
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Fax | 407-977-4402
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Provider Business Mailing Address
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Address Line | 2538 FLOWERING DOGWOOD DR
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City | ORLANDO
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State | FL
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Zip | 32828-4828
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Country | US
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Telephone | 407-977-4448
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Fax | 407-977-4402
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. DENA HUNTLEY HOY
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Credential | MA,CCC-SPL
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Telephone | 407-977-4448
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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 | SA6612
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License Number State | FL
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