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Organization
MARIPOSA SPEECH THERAPY LLC
Active
Organization
MARIPOSA SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA BIDSTRUP M.A., CCC-SLP (MANAGER)
(208) 757-3250
Entity
Organization
Contact information
Practice address
60 YACHT CLUB DR NE APT 10, FORT WALTON BEACH, FL 32548-8800
(208) 757-3250
Mailing address
60 YACHT CLUB DR NE APT 10, FORT WALTON BEACH, FL 32548-8800
(208) 757-3250
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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