MEDICARE: AIM 2 ACHIEVE SPEECH THERAPY & LEARNING CENTER

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
1	235Z00000X	Speech-Language Pathologist	SA7486	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366751885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIM 2 ACHIEVE SPEECH THERAPY & LEARNING CENTER

Provider Business Mailing Address
First Line	:	622 DUNLIN LN
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-4534
Country	:	US
Telephone Number	:	407-329-3442
Fax Number	:	407-329-8170

Provider Business Practice Location Address
First Line	:	651 E MAIN ST STE 4
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-4241
Country	:	US
Telephone Number	:	407-329-3442
Fax Number	:

Authorized Official
Title or Position	:	P
Name	:	PAMELA JACKMAN
Credential	:
Telephone Number	:	407-329-3442

Provider Enumeration Date	:	10/01/2010
Last Update Date	:	06/07/2023

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Directions to “AIM 2 ACHIEVE SPEECH THERAPY & LEARNING CENTER ” Practice Location

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