MEDICARE: ENCORE SPEECH & WELLNESS, LLC

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

General Provider Information

NPI Number	:	1821804329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE SPEECH & WELLNESS, LLC

Provider Business Mailing Address
First Line	:	132 RAINBOW ST
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-6241
Country	:	US
Telephone Number	:	909-289-3406
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FORTENBERRY RD STE B
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32952-3522
Country	:	US
Telephone Number	:	321-292-2268
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ SPEECH PATHOLOGIST
Name	:	MRS. MAIJA CULTER HAHN
Credential	:	M.S., CCC-SLP
Telephone Number	:	321-292-2268

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	12/09/2024

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Directions to “ENCORE SPEECH & WELLNESS, LLC ” Practice Location

Language	Start Address	Practice Location

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