MEDICARE: HAPPY CAMPER SPEECH THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	252Y00000X	Early Intervention Provider Agency
2	261Q00000X	Clinic/Center
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1427850189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAPPY CAMPER SPEECH THERAPY LLC

Provider Business Mailing Address
First Line	:	180 SCHNEIDER DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-2726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 SCHNEIDER DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-2726
Country	:	US
Telephone Number	:	239-310-1081
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MARY K ADAMS
Credential	:	MS, CCC-SLP
Telephone Number	:	239-310-1081

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	05/08/2025

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