MEDICARE: SPEAK EASY OF THE PALM BEACHES INC

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	SA 9463	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

General Provider Information

NPI Number	:	1528592706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEAK EASY OF THE PALM BEACHES INC

Provider Business Mailing Address
First Line	:	2608 ACKLINS RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7750
Country	:	US
Telephone Number	:	813-990-7170
Fax Number	:	561-225-1718

Provider Business Practice Location Address
First Line	:	2608 ACKLINS RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7750
Country	:	US
Telephone Number	:	813-990-7170
Fax Number	:	561-225-1718

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MRS. MEGHAN MCKENNA CALLA
Credential	:	M.S. CCC-SLP
Telephone Number	:	813-990-7170

Provider Enumeration Date	:	04/14/2017
Last Update Date	:	04/14/2017

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Directions to “SPEAK EASY OF THE PALM BEACHES INC ” Practice Location

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