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General NPI Number Information
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NPI Number | 1821490277
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Entity Type | Organization
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Legal Business Name | SPEECH CONCEPTS, INC.
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 32 SE 2ND AVE UNIT 539
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3643
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Country | US
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Telephone | 570-573-0258
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Fax |
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Provider Business Mailing Address
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Address Line | 32 SE 2ND AVE UNIT 539
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3643
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Country | US
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Telephone | 570-573-0258
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMANDA WAGNER
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Credential |
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Telephone | 570-573-0258
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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 | 11554
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License Number State | FL
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