NPI 1487364162 · live from the CMS NPI Registry
Mallory Elise Abercrombie
Speech-Language Pathologist, in Ponte Vedra, FL. National Provider Identifier 1487364162, active.
NPI record
| NPI | 1487364162 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 95 Tavernier Dr, Ponte Vedra, FL 32081 |
| Practice phone | 904-729-6759 |
| Mailing address | 7279 San Pedro Rd, Jacksonville, FL 32217 |
| Enumerated | December 2, 2022 |
| Last updated | December 2, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | SA20932 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.