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General NPI Number Information
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NPI Number | 1881140036
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Entity Type | Individual
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Provider Name | SANDRA NALLEY
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 1000 W BROADWAY ST STE 214
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City | OVIEDO
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State | FL
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Zip | 32765-9262
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Country | US
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Telephone | 407-359-5693
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Fax | 407-792-5693
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Provider Business Mailing Address
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Address Line | 2033 COVE TRL
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City | WINTER PARK
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State | FL
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Zip | 32789-1158
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Country | US
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Telephone | 610-764-0554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SA13092
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License Number State | FL
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