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General NPI Number Information
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NPI Number | 1952949638
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Entity Type | Organization
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Legal Business Name | RISE SPEECH AND SWALLOW SOLUTIONS
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 6916 STONESTHROW CIR N APT 9102
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-4765
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Country | US
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Telephone | 248-568-1421
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Fax |
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Provider Business Mailing Address
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Address Line | 6916 STONESTHROW CIR N APT 9102
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-4765
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Country | US
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Telephone | 248-568-1421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATLYN GOLLIN
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Credential |
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Telephone | 248-568-1421
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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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