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Organization
PARADISE COAST SPEECH THERAPY, LLC
Active
Organization
PARADISE COAST SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA B PENN MS CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(239) 580-8884
Entity
Organization
Contact information
Practice address
1290 SPERLING CT, NAPLES, FL 34103-2328
(239) 580-8884
Mailing address
1289 SPERLING CT, NAPLES, FL 34103-2328
(239) 580-8884
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 10710
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01101838
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
MD
01
—
SA 10710
STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
04/01/2011
Last updated
04/01/2011
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