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Organization
RIVERSIDE SPEECH & LANGUAGE LLC
Active
Organization
RIVERSIDE SPEECH & LANGUAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ROYALL MS CCC-SLP (SPEECH & LANGUAGE PATHOLOGIST)
(941) 807-2863
Entity
Organization
Contact information
Practice address
808 HILLCREST DR, BRADENTON, FL 34209-1846
(941) 807-2863
Mailing address
808 HILLCREST DR, BRADENTON, FL 34209-1846
(941) 807-2863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7630
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
888666100
—
FL
Enumeration date
12/06/2008
Last updated
12/06/2008
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