Organization Name: | KIX4KIDSTHERAPY |
NPI Number: | 1942517636 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL J RIDDLE (PRESIDENT) |
Mailing Address: | 3381 Mariner Blvd Spring Hill |
State: | FL US |
Postal Code: | 346092461 |
Phone Number: | 3525855234 |
Fax Number: | 3526783730 |
NPI Enumeration Date: | 09/02/2010 |
NPI Last Update Date: | 09/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA9778 |
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 |