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General NPI Number Information
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NPI Number | 1912412339
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Entity Type | Organization
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Legal Business Name | RIPPLE LANGUAGE, LLC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 1929 HAMMERLIN AVE
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City | WINTER PARK
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State | FL
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Zip | 32789-6609
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Country | US
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Telephone | 407-432-1597
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Fax |
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Provider Business Mailing Address
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Address Line | 11125 PARK BLVD STE 104-182
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City | SEMINOLE
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State | FL
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Zip | 33772-4757
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Country | US
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Telephone | 407-432-1597
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. MARY LONGO
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Credential | M.S. CCC-SLP
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Telephone | 407-432-1597
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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 | SA6858
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License Number State | FL
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