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Organization
SPEECH THERAPY PATHWAY
Active
Organization
SPEECH THERAPY PATHWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE LIA HAQQ SLP-CCC (OWNER)
(813) 385-4610
Entity
Organization
Contact information
Practice address
36750 US HIGHWAY 19 N UNIT 3229, PALM HARBOR, FL 34684-1239
(813) 385-4610
Mailing address
36750 US HIGHWAY 19 N UNIT 3229, PALM HARBOR, FL 34684-1239
(813) 385-4610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285292805
—
FL
Enumeration date
07/13/2024
Last updated
07/21/2024
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