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General NPI Number Information
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NPI Number | 1821749631
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Entity Type | Organization
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Legal Business Name | SPEECH RECOVERY LLC
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 11111 BISCAYNE BLVD # 312
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3404
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Country | US
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Telephone | 901-246-5730
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Fax |
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Provider Business Mailing Address
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Address Line | 11111 BISCAYNE BLVD # 312
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE THERAPIST
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Name | SAMANTHA BYNUM
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Credential | SLP
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Telephone | 901-246-5730
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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 |
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