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General NPI Number Information
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NPI Number | 1992128953
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Entity Type | Organization
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Legal Business Name | ANCHOR SPEECH AND LANGUAGE, LLC
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 2343 SUNSET BLUFF DR
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4703
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Country | US
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Telephone | 518-986-4089
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Fax |
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Provider Business Mailing Address
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Address Line | 2343 SUNSET BLUFF DR
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4703
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Country | US
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Telephone | 518-986-4089
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETHANY L WALKER
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Credential | MS, CCC-SLP
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Telephone | 518-986-4089
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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 | SA9596
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License Number State | FL
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