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Organization
LACTATION, EARLY INTERVENTION, AND FEEDING THERAPIES
Active
Organization
LACTATION, EARLY INTERVENTION, AND FEEDING THERAPIES
Active
Other names
LEIF Therapies
Organization subpart
No
Provider details
NPI number
Authorized official
AMELIA FRY MS, CCC-SLP, IBCLC (SPEECH LANGUAGE PATHOLOGIST)
(772) 485-4357
Entity
Organization
Contact information
Practice address
615 SE HIBISCUS AVE, STUART, FL 34996-3602
(772) 485-4357
Mailing address
615 SE HIBISCUS AVE, STUART, FL 34996-3602
(772) 485-4357
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
L-111185
—
235Z00000X
Speech-Language Pathologist
Primary
SA 11146
FL
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004024000
—
FL
01
—
14030798
AMERICAN SPEECH AND HEARING ASSOCIATION
—
01
—
L-111185
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
—
Enumeration date
01/26/2016
Last updated
03/15/2017
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