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NPI Code Detail

MEDICARE: FELICIA PETERS MS CCC SLP

MEDICARE: FELICIA PETERS MS CCC SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 11906FL

General Provider Information

NPI Number : 1003154865
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICIA PETERS MS CCC SLP
Provider Business Mailing Address
First Line : 26850 S BAY DR
Second Line :
City : BONITA SPRINGS
State : FL
Zip : 34134-4379
Country : US
Telephone Number : 239-948-2600
Fax Number :
Provider Business Practice Location Address
First Line : 26850 S BAY DR
Second Line :
City : BONITA SPRINGS
State : FL
Zip : 34134-4379
Country : US
Telephone Number : 239-948-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2013
Last Update Date : 01/29/2013

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Directions to “ FELICIA PETERS MS CCC SLP” Practice Location

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