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General NPI Number Information
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NPI Number | 1992257422
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Entity Type | Organization
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Legal Business Name | TUBES 2 TABLES, INC
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 1290 E NINE MILE RD STE B
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City | PENSACOLA
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State | FL
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Zip | 32514-1653
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Country | US
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Telephone | 850-857-9343
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Fax | 844-848-7557
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Provider Business Mailing Address
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Address Line | 1290 E NINE MILE RD STE B
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City | PENSACOLA
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State | FL
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Zip | 32514-1653
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Country | US
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Telephone | 850-857-9343
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Fax | 844-848-7557
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | NEINA F FERGUSON
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Credential | PH.D., CCC-SLP
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Telephone | 850-857-9343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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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 | SA6756
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License Number State | FL
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