Doctor Name: | ASHLEY MICHELLE RETZ |
NPI Number: | 1447503248 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SA 1120 |
Business Practice Address: | 389 Palm Coast Pkwy Sw Suite 1 Palm Coast, FL - 321374771 |
Business Phone Number: | 3865972820 |
Business Fax Number: | 3865972820 |
Mailing Address: | 389 Palm Coast Parkway, Suite 1 PALM COAST |
State: | FL |
Postal Code: | 32137 |
Phone Number: | 3865972820 |
Fax Number: | 3865972820 |
NPI Enumeration Date: | 10/18/2012 |
NPI Last Update Date: | 10/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 1120 |
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 |