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General NPI Number Information
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NPI Number | 1821804329
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Entity Type | Organization
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Legal Business Name | ENCORE SPEECH & WELLNESS, LLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 400 FORTENBERRY RD STE B
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-3522
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Country | US
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Telephone | 321-292-2268
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Fax |
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Provider Business Mailing Address
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Address Line | 132 RAINBOW ST
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-6241
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Country | US
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Telephone | 909-289-3406
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Fax |
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Authorized Official
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Title or Position | OWNER/ SPEECH PATHOLOGIST
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Name | MRS. MAIJA CULTER HAHN
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Credential | M.S., CCC-SLP
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Telephone | 321-292-2268
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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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