Doctor Name: | RYANNE RENEE PETROF |
NPI Number: | 1366695157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SZ4638 |
Business Practice Address: | 3496 Nw Federal Hwy Suite G Jensen Beach, FL - 349574441 |
Business Phone Number: | 7722235677 |
Business Fax Number: | |
Mailing Address: | 7435 Pine Lakes Blvd, PORT ST LUCIE |
State: | FL |
Postal Code: | 349521513 |
Phone Number: | 4077442280 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2008 |
NPI Last Update Date: | 10/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ4638 |
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 |