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General NPI Number Information
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NPI Number | 1902661176
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Entity Type | Organization
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Legal Business Name | LITTLE BRIDGES SPEECH THERAPY, LLC.
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 301 FLAMINGO DR
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City | SAINT MARYS
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State | GA
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Zip | 31558-3628
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Country | US
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Telephone | 912-406-2495
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Fax |
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Provider Business Mailing Address
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Address Line | 301 FLAMINGO DR
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City | SAINT MARYS
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State | GA
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Zip | 31558-3628
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Country | US
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Telephone | 269-598-8070
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | ELIANA RODRIGUEZ
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Credential | M.ED., CCC-SLP
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Telephone | 269-598-8070
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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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