Doctor Name: | LAURIE ANN WELLS |
NPI Number: | 1780987271 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SA10305 |
Business Practice Address: | 2226 Sarno Rd Suite 101 Melbourne, FL - 329353087 |
Business Phone Number: | 3212414816 |
Business Fax Number: | 3212414817 |
Mailing Address: | 1985 Flashy Ln, Fl MALABAR |
State: | FL |
Postal Code: | 329503143 |
Phone Number: | 3212414816 |
Fax Number: | 3212414817 |
NPI Enumeration Date: | 12/06/2010 |
NPI Last Update Date: | 03/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA10305 |
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 |