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Organization
SPEECH PATHWAYS OF ST. JOHNS
Active
Organization
SPEECH PATHWAYS OF ST. JOHNS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARISSA ANNE GUSSMANN CCC-SLP (MANAGER/OWNER)
(908) 770-5990
Entity
Organization
Contact information
Practice address
12627 SAN JOSE BLVD STE 803, JACKSONVILLE, FL 32223-8644
(908) 770-5990
Mailing address
609 FORT WILLIAM DR, SAINT JOHNS, FL 32259-5925
(908) 770-5990
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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