| Doctor Name: | RYANN VANESSA ENNIS |
| NPI Number: | 1629304027 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SPEECH/LANGUAGE PATH |
| License Number: | SA8416 |
| Business Practice Address: | 1005 Mar Walt Drive Otolaryngology Department Fort Walton Beach, FL - 325476796 |
| Business Phone Number: | 8508638275 |
| Business Fax Number: | 8503146833 |
| Mailing Address: | 1005 Mar Walt Drive, Otolaryngology Department FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325476796 |
| Phone Number: | 8508638275 |
| Fax Number: | 8503146833 |
| NPI Enumeration Date: | 10/20/2009 |
| NPI Last Update Date: | 10/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA8416 |
| 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 |