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General NPI Number Information
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NPI Number | 1851083059
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Entity Type | Organization
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Legal Business Name | THRIVING JOY PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 16359 FREHLEY RUN
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City | LAND O LAKES
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State | FL
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Zip | 34638-4414
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Country | US
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Telephone | 813-563-8699
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Fax |
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Provider Business Mailing Address
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Address Line | 16359 FREHLEY RUN
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City | LAND O LAKES
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State | FL
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Zip | 34638-4414
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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 | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | JAIME KALEY PEREZ
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Credential | SLP
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Telephone | 813-563-8699
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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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