Organization Name: | BEACHES SPEECH THERAPY |
NPI Number: | 1104223395 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELANIE P DESMOND (OWNER) |
Mailing Address: | 128 Woodlands Creek Dr Ponte Vedra Beach |
State: | FL US |
Postal Code: | 320823217 |
Phone Number: | 9046163455 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2014 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA6650 |
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 |