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Organization
JOLEEN R. FERNALD PEDIATRIC THERAPY SERVICES
Active
Organization
JOLEEN R. FERNALD PEDIATRIC THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOLEEN FERNALD PHD, CCC-SLP, BCS-CL (OWNER)
(603) 498-7825
Entity
Organization
Contact information
Practice address
2114 SEVEN SPRINGS BLVD STE 200, NEW PORT RICHEY, FL 34655-3934
(603) 498-7825
Mailing address
1820 KINSMERE DR, TRINITY, FL 34655-4531
(603) 498-7825
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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