Doctor Name: | JUSTIN KRELLIN |
NPI Number: | 1275954745 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | SZ6458 |
Business Practice Address: | 12729 Nw 18th Mnr Coral Springs, FL - 330715410 |
Business Phone Number: | 9548713345 |
Business Fax Number: | |
Mailing Address: | 12729 Nw 18th Mnr, CORAL SPRINGS |
State: | FL |
Postal Code: | 330715410 |
Phone Number: | 9548713345 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2013 |
NPI Last Update Date: | 12/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ6458 |
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 |