Organization Name: | JD SPEECH PATHOLOGIST AND ASSOCIATES, LLC |
NPI Number: | 1093154148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER L. FANIEL (SPEECH-LANGUAGE PATHOLOGIST) |
Mailing Address: | 4000 Central Florida Blvd Orlando |
State: | FL US |
Postal Code: | 328168005 |
Phone Number: | 8778520246 |
Fax Number: | 8779045749 |
NPI Enumeration Date: | 06/21/2013 |
NPI Last Update Date: | 06/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |