Doctor Name: | JENNIE MIDDLEMAS |
NPI Number: | 1770639338 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED CCC-SLP |
License Number: | SA4536 |
Business Practice Address: | 2532 W Indiantown Rd Suite 2 Jupiter, FL - 334583935 |
Business Phone Number: | 5617485430 |
Business Fax Number: | 5617485442 |
Mailing Address: | 4370 Fuschia Cir S, PALM BEACH GARDENS |
State: | FL |
Postal Code: | 334105431 |
Phone Number: | 5616269886 |
Fax Number: | |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA4536 |
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 |