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Organization
MDP SPEECH LANGUAGE THERAPY, PA
Active
Organization
MDP SPEECH LANGUAGE THERAPY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA PENDLEY (OWNER)
(239) 248-0458
Entity
Organization
Contact information
Practice address
6561 CHESTNUT CIR, NAPLES, FL 34109-7811
(239) 248-0458
Mailing address
6561 CHESTNUT CIR, NAPLES, FL 34109-7811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA4153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
599035
—
FL
Enumeration date
09/10/2015
Last updated
09/10/2015
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