Doctor Name: | MRS. KOREN LYNN TOLENTINO |
NPI Number: | 1225164106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SA8896 |
Business Practice Address: | 14444 Beach Blvd Suite 500 Jacksonville, FL - 322502079 |
Business Phone Number: | 9048587510 |
Business Fax Number: | 9048587540 |
Mailing Address: | 13364 Beach Blvd Unit 204, JACKSONVILLE |
State: | FL |
Postal Code: | 322240265 |
Phone Number: | 9042231075 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA8896 |
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 |