NPI 1972023620 · live from the CMS NPI Registry
A Place To Grow Pediatric Therapy
Speech-Language Pathologist, in Palm Coast, FL. National Provider Identifier 1972023620, active.
NPI record
| NPI | 1972023620 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 64 Rollins Ln, Palm Coast, FL 32164 |
| Practice phone | 352-359-1725 |
| Enumerated | June 23, 2017 |
| Last updated | July 21, 2022 |
| Authorized official | Aimee Mahoney, Owner/Speech-Language Pathologist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | SA11599 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.