Organization Name: | KIDS ON A ROLL-FLEMING ISLAND |
NPI Number: | 1871644427 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY B. COHILL (OWNER) |
Mailing Address: | 855 S Holmes Blvd Saint Augustine |
State: | FL US |
Postal Code: | 320848347 |
Phone Number: | 9045408408 |
Fax Number: | 9047971627 |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA3573 |
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 |