Organization Name: | TC SPEECH, LLC |
NPI Number: | 1063767374 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACY RENEE CLOUSE-NORD (SPEECH LANGUAGE PATHOLOGIST) |
Mailing Address: | 4696 Country Manor Dr Sarasota |
State: | FL US |
Postal Code: | 342331855 |
Phone Number: | 9414160511 |
Fax Number: | 9419214129 |
NPI Enumeration Date: | 07/24/2012 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA8912 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |