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Organization
JANET S MOULTON INC
Active
Organization
JANET S MOULTON INC
Active
Other names
Pediatric Therapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JANET S MOULTON SLP (OWNER)
(904) 249-8893
Entity
Organization
Contact information
Practice address
340 16TH AVE N, STE B, JACKSONVILLE BEACH, FL 32250-4819
(904) 249-8893
(904) 372-0496
Mailing address
340 16TH AVE N, STE B, JACKSONVILLE BEACH, FL 32250-4819
(904) 249-8893
(904) 372-0496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
SA4951
FL
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884273600
—
FL
01
—
S1828
BC/BS
FL
Enumeration date
06/08/2006
Last updated
10/25/2022
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