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NPI Code Detail

MEDICARE: MRS. IVORIANN FRANCES WOOLEY M.A., CCC-SLP

MEDICARE: MRS. IVORIANN FRANCES WOOLEY M.A., 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 11229FL

General Provider Information

NPI Number : 1467750943
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IVORIANN FRANCES WOOLEY M.A., CCC-SLP
Provider Business Mailing Address
First Line : 3260 N HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6203
Country : US
Telephone Number : 321-693-8196
Fax Number : 321-373-4007
Provider Business Practice Location Address
First Line : 3260 N HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6203
Country : US
Telephone Number : 321-693-8196
Fax Number : 321-373-4007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2011
Last Update Date : 03/17/2018

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Directions to “ MRS. IVORIANN FRANCES WOOLEY M.A., CCC-SLP” Practice Location

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