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General NPI Number Information
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NPI Number | 1912300930
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Entity Type | Organization
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Legal Business Name | EC SPEECH AND LANGUAGE THERAPY INC
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Dates
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Enumeration Date | 10/04/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 3407 PACIFIC DR
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City | NAPLES
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State | FL
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Zip | 34119-8664
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Country | US
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Telephone | 239-595-9972
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Fax |
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Provider Business Mailing Address
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Address Line | 3407 PACIFIC DR
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City | NAPLES
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State | FL
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Zip | 34119-8664
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Country | US
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Telephone | 239-595-9972
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ELISABETH CAMP-GERMANN
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Credential | CCC-SLP
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Telephone | 239-595-9972
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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 | SA9221
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA12682
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License Number State | FL
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