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Organization
THE SPEECH LAB, LLC
Active
Organization
THE SPEECH LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN T FAITH (OWNER)
(918) 698-5560
Entity
Organization
Contact information
Practice address
898 HIGHWAY 98 E, DESTIN, FL 32541-2700
(918) 698-5560
Mailing address
200 WEKIVA CV, DESTIN, FL 32541-4763
(918) 698-5560
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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