Basic Information
| Provider Information | |||||||||
| NPI: | 1558694331 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SPEECHWORKS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3225 S MACDILL AVE | ||||||||
| Address2: | SUIT #129-333 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336298171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134942637 | ||||||||
| FaxNumber: | 8138393639 | ||||||||
| Practice Location | |||||||||
| Address1: | 3225 S MACDILL AVE | ||||||||
| Address2: | SUIT #129-333 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336298171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134942637 | ||||||||
| FaxNumber: | 8138393639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2009 | ||||||||
| LastUpdateDate: | 09/11/2009 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GIVENS | ||||||||
| AuthorizedOfficialFirstName: | ASHLI | ||||||||
| AuthorizedOfficialMiddleName: | ELIZABETH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8134942637 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | M.S., CCC/SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA7910 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.